Introduction

Benign ovarian teratomas classically exhibit a variety of tissues derived from all three germ cell layers. Daponte et al. [1] presented a case coexisting with pregnancy because of its being exceedingly rare and tabulated 15 examples detected in the world literature. Therefore, from the vantage point of having previously written generally on teratomas [2], which manifested in surgical specimens removed from patients of the Ibo or Igbo ethnic group [3], twenty cases obtained locally are deemed to be worthy of report with reference to 30-year period as regards cesarean section cases. In the opinion of Macartney [4], the histopathology data pool is useful in epidemiological research. The employment of it in the present paper is therefore of material importance.

Case Report

The opportunity offered by the establishment of a Reference Pathology Laboratory facilitated in collection of a data pool from 1970-2000.

Results

These are presented in Table 1.

Discussion

In general, the removal of an adnexal mass is indicated for various reasons including the danger of developing malignancy [5,6]. In this context, acute pain due to torsion is reportedly uncommon [7]. None of the present cases was of this type. Nor was any associated with the super infection which has previously been recorded [8].

Recorded age range ranged from 16 years to 42 years with a mean of 30.7 years. Four patients were primiparous, the highest parity being 10. Two cases were involved bilaterally, the two sides being affected equally. The specimens ranged in size from 2 cm to 10 cm and averaged 6.3 cm. Of the etiology, obstructed labor stood out and so did previous cesarean sections cases.

Cases mostly came from Enugu itself, while Missionary Hospitals situated in two towns also featured. One gynecologist submitted 3 specimens; two others supplied two specimens each, while as many as 13 individual gynecologists made use of the relatively free Reference facility which was at their disposal.

Conclusion

Disposal of materials excised at gynecological operations is a routine in developed countries but a matter for concern in developing countries. However, concerning ovarian masses removed during cesarean sections in underdeveloped countries, it is recommended that excised specimens should be sent always for histology. It is concluded that the present series, which involved an ethnic group in Nigeria, West Africa, has added to the epidemiologic knowledge of this interesting subject, especially as it cited the literature which covered different countries [1,5-8]. Accordingly, the results are probably epidemiologically of interest worldwide. In this context, it is to be hoped that preoperative examinations are worthy of recommendation, especially as development improves everywhere.

1. Daponte A, Kostopoulou E, Zavos A, Skentou H, Kallitsaris A, et al. (2008) Immature teratoma in pregnancy: a case report and literature review. Eur J Gynaec Oncol 29(3): 300-304.
2. Onuigbo WIB (1976) Teratomas in the Igbos of Nigeria. J Natl Cancer Inst 57(5): 1191-1192.
3. Basden GT (1966) Niger Ibos. Cass, London, UK.
4. Macartney JC, Rollaston TP, Codling BW (1980) Use of a histopathology data pool for epidemiological analysis. J Clin Pathol 33(4): 351-355.
5. Maiti S, Fatima Z, Anjum ZK, Hopkins RE (2008) Ruptured ovarian cystic teratoma in pregnancy with diffuse peritoneal reaction mimicking advanced ovarian malignancy: a case report. J Med Case Rep 2: 203.
6. Perez-Lopez FR, Chedrani P, Troyano-Lugue JM (2010) Peri- and post-menopausal incidental adnexal masses and the risk of sporadic ovarian malignancy: new insights and clinical management. Gynecol Endocrinol 26(9): 631-643.
7. Tan KH, Chen KC, Wang TL, Chong CF, Chen CC (2010) Ovarian cystic teratoma torsion in pregnancy. Emerg Med J 27(11): 879-880.
8. Luk JL, Quaas A, Garner E (2007) The superinfection of a dermoid cyst. Infect Dis Obstet Gynecol 2007: 41473. DOI: 10.1155/2007/41473.

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  Table 1: Shows the parameters of 20 cases of benign ovarian teratomas excised at cesarean section in Nigeria. Only the noted data are analyzed.