A 28-year-old woman presents with acute right lower quadrant pain. Ultrasound shows a 7 cm left ovarian cyst with fat-fluid level and a Rokitansky nodule. Which complication is she at highest risk for if managed conservatively?
- A Torsion ✓
- B Rupture with chemical peritonitis
- C Malignant transformation
- D Autoimmune hemolytic anemia
Correct answer: A. Torsion
Explanation
The fat-fluid level and Rokitansky nodule are pathognomonic for mature cystic teratoma (dermoid cyst). These tumors are pedunculated and heavy, making torsion the most common acute complication. Rupture is rare, malignant transformation occurs in under 2 percent (usually squamous cell carcinoma in postmenopausal women), and autoimmune hemolytic anemia is a rare association, not the most immediate risk.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.