Multiple and Bilobed Ovarian Dermoid Cysts: Complications and their Successful Laparoscopic Management

Background: Ovarian dermoid is one of the commonly occurring ovarian neoplasms in young women but the occurrence of multiple dermoid cysts is comparatively rare. Case description: This is a case of 24-year-old woman who ignored her first diagnosis and management plan for a 3 × 3 cm dermoid cyst in one of the ovaries and later returned with severe symptoms of abdominal pain and vomiting and with a CT scan diagnosis of bilateral, large (7 × 7 cm) dermoid cysts. She was prepared for laparoscopic bilateral dermoid cyst excision, until the intraoperative scenario, revealing right- sided twisted bilobed dermoid cyst and left-sided twin dermoid cysts changed the original plan. Finally, the patient underwent right-sided ovariotomy with right-sided salpingectomy and left-sided twin dermoid cysts excision. Conclusion: Laparoscopy is the surgical mode of choice in dermoid presentations. Evaluation of contralateral ovary must be carried out while dealing with dermoid cyst of one ovary. Clinical significance: Torsion of a large dermoid cyst is not an indication for ovariotomy. However, ischemic dermoid cysts require an on-table judgement for cystectomy or ovariotomy. Laparoscopic management in skilled hands favors cystectomy. Examining contralateral ovary must be a routine while operating on a patient with dermoid cysts in ovary.