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Topical Hemostatic Agent May Be Mistaken for Ovarian Teratoma

  • Katherine G. Hayes
    Affiliations
    Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts
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  • Amanda V. French
    Correspondence
    Address correspondence to: Amanda V. French, Tufts Medical Center, Department of Obstetrics and Gynecology, 800 Washington Street, Boston, MA 02110; Phone (617) 636-2229.
    Affiliations
    Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts

    Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts
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Published:December 03, 2021DOI:https://doi.org/10.1016/j.jpag.2021.12.001

      Abstract

      Background

      Ovarian teratomas are common, as is use of topical hemostatic agents in ovarian surgery.

      Case

      Following laparoscopic right ovarian cystectomy, a flowable hemostatic agent was placed in the ovarian bed. Postoperative ultrasound demonstrated an enlarged heterogeneous right ovary with solid and cystic components interpreted as residual or recurrent teratoma. Visual inspection during repeat laparoscopy revealed an irregularly shaped, enlarged right ovary with a smooth cortex. A cavity inside the ovary contained brown, shaggy material. Pathological evaluation demonstrated normal ovary and fibrin.

      Summary and Conclusion

      We report the first case of a hemostatic agent routinely used in ovarian cystectomy postoperatively, mimicking a teratoma. Consideration of this finding is important when planning surgery in adolescent patients to optimize fertility preservation and minimize ovarian follicle damage.

      Keywords

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