Dagnachew Tilksew

University of Rwanda
Rwanda

Abstract Title: Auto?amputated dermoid cyst with secondary torsion during pregnancy: a case report

Biography: Dr. Dagnachew Tilksew is an obstetrician and gynecologist at the University of Rwanda, Kirehe Level II Teaching Hospital. His clinical and academic focus is on maternal and neonatal health, with particular interest in rare surgical emergencies during pregnancy. He has authored case reports and presented at international conferences. Dr. Tilksew is committed to advancing maternal?fetal outcomes through scholarly collaboration and is actively engaged in teaching and mentoring residents in obstetrics and gynecology.

Research Interest: Background: Parasitic ovarian tumors arising from adnexal autoamputation are exceptionally rare. To the best of our knowledge, secondary torsion of such tumors during pregnancy has not been reported previously. Case Presentation: A 24?year?old gravida 2 para 1 woman at 21 weeks’ gestation presented with acute periumbilical pain and vomiting, initially suspected to be threatened abortion. Six months prior, she had been diagnosed with a large ovarian dermoid cyst but was lost to follow?up. She later presented with a first-trimester pregnancy, and surgery was rescheduled for the second trimester; however, she missed the appointment. At 21 weeks of gestation, the patient presented with severe abdominal pain. Examination revealed a mobile abdominopelvic mass extending to the left subcostal area, rebound tenderness, a gravid uterus consistent with 22 weeks, and positive fetal heart activity. Emergency laparotomy revealed a giant parasitic ovarian dermoid tumor measuring 22 × 22 cm, which was twisted 360° anticlockwise from a pedicle attached to the abdominal wall peritoneum. Ovarian tissue and fimbrial structures were visible on the tumor surface, with vascular supply from the anterior abdominal wall and omentum. The left adnexa and the gravid uterus appeared normal. Complete excision with partial omentectomy was performed. Histopathology confirmed mature cystic teratoma. The recovery was uneventful, and fetal well?being was preserved. Discussion: This case illustrates a rare nonobstetric cause of acute abdomen during pregnancy. The parasitic nature of the tumor and its secondary torsion highlight the importance of considering unusual surgical emergencies in pregnant patients. Conclusion: To the best of the authors knowledge, this is the first reported case of secondary torsion of a parasitic ovarian dermoid tumor during pregnancy. Prompt recognition and timely surgical intervention are critical to safeguarding maternal and fetal outcomes