[Ovarian cyst and pregnancy. Conservative management and consecutive emergency cystectomy. Case report]. / Chist ovarian asociat cu sarcina. Conduita conservativa si chistectomie intempestiva ulterioara. Caz clinic.

The association of an ovarian cyst with pregnancy is relatively rare; it may result in serious maternal and fetal complications and its treatment is still controversial. We present a case in which the rarity is given by the association of an 11cm--serous right ovarian cyst (with signs of torsion) with a monofetal 6 gestation week--pregnancy, by the initial conservative management and by the subsequent laparotomy and cystectomy at 16 gestational weeks, required by the acute abdominal pain caused by the torted cyst. The approach was initially conservative followed by laparotomy and cystectomy at 16 gestation weeks, required by the acute abdominal pain caused by the torsive cyst. Pregnancy was, afterwards, uneventful and the patient delivered vaginally, at term, a 3200 g healthy girl. Management options of such a case are discussed.

Asymptomatic abdominal wall endometrioma 15 years after cesarean section.

Abdominal wall endometriosis is rare and its diagnosis is difficult. However, the consequences may be serious, like recurrences or even malignant transformation. We report a rarer case of asymptomatic abdominal wall endometrioma, accidentally found during a surgical procedure for a second cesarean section, in a 39-years old patient, without any relevant history of endometriosis. The tumor was subcutaneous, 3/3 cm in size, located in the left angle of the incision from the 15 years previously performed cesarean section and freely mobile in relation with the skin and the fascia. It was excised, with clear margins (to prevent recurrences), during the procedure. The patient was discharged after five days. The postoperative period and the follow-up at one and three months were uneventful. The pathological examination clarified the diagnosis by revealing an endometrioma with decidual reaction. Such a condition may be, therefore, evoked before an abdominal wall tumor, even without specific symptoms, even in a 39-years old woman and longtime after the possible causal surgery. Pathological examination remains the ultimate diagnostic tool. Relevant prophylactic attitude at the end of the cesarean section may be considered.