Mature teratomas are benign adnexal masses comprising 10 - 25% of ovarian neoplasms. They commonly present with abdominal pain and are associated with adnexal torsion in 15% of cases. Malignant transformation is rare ( < 2%). Due to a relatively thick cyst wall, spontaneous cyst rupture is uncommon (2 - 4%). Fever can be associated with torsion or cyst rupture but is rarely secondary to infection. We describe an unusual presentation of a mature teratoma in a pediatric patient who presented with systemic inflammatory response syndrome (SIRS).
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