A 22-year-old presents with acute lower abdominal pain, nausea, and vomiting. Ultrasound shows a 7 cm right ovarian cyst with absent blood flow on Doppler. At laparoscopy, the ovary is found to be dusky blue-black with a twisted pedicle. The most common type of ovarian cyst that undergoes torsion is:

• A Follicular cyst
• B Endometrioma
• C Mucinous cystadenoma
• D Dermoid cyst (mature cystic teratoma) ✓

Explanation

Mature cystic teratoma (dermoid cyst) is the most common benign ovarian tumor and the most common ovarian tumor to undergo torsion, accounting for approximately 15-20% of all torsion cases. Dermoids are often large, have a heavy sebaceous component that shifts the center of gravity, making them prone to twisting on the infundibulopelvic ligament. Follicular cysts are typically small and less prone to torsion; endometriomas have adhesions that paradoxically prevent torsion. Treatment is laparoscopic detorsion with cystectomy.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.