ABSTRACT
INTRODUCTION AND IMPORTANCE: Malignant transformation of ovarian teratomas is rare, provoking peritonitis and death are exceedingly rare. CASE PRESENTATION: We present the case of a 75-year-old woman who was admitted to the emergency department for severe abdominal pain with septic shock due to acute peritonitis caused by perforation of the ovarian mass. CLINICAL DISCUSSION: Teratomas are germ cell tumors usually composed of multiple cell types derived from one or more of the three germ layers. Pathologically, malignant transformation of ovarian dermoid cysts is rare due to the thickness of the capsule, spontaneous rupture is a very rare complication, acute peritonitis presents with features of acute abdomen or shock, treatment is essentially surgical and includes at least unilateral adnexectomy, complete exploration of the pelvis and abdominal cavity, peritoneal washing and/or sampling of any ascites. CONCLUSION: In conclusion, although ovarian teratoma with granulomatous peritonitis is rare, rupture leading to generalised acute peritonitis further worsens the prognosis. Which will ensure correct management that will provide a good outcome with less complications.