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Vegetable fibre in an infected ovarian dermoid cyst
  1. Carla M Villarreal,
  2. Srikala Yedavally and
  3. Elie Mulhem
  1. Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
  1. Correspondence to Carla M Villarreal, cmvillarreal{at}


Tubo-ovarian abscesses (TOAs) are inflammatory masses involving the fallopian tube, ovary and occasionally other adjacent pelvic organs. A 32-year-old woman with no significant medical history presented with a chief complaint of lower abdominal pain. Initial CT of the abdomen was suggestive of a colon abscess; however, a repeat CT suggested a TOA. The left ovary was densely adherent to the left pelvic sidewall and the rectosigmoid colon. The content of the ovary was consistent with a dermoid and suspected of superinfection. Pathological examination of the tissue revealed normal ovarian cortical tissue, hair cells, melanin, and epidermal and neural tissue, as well as evidence of a foreign object resembling vegetable matter. The vegetable fibre found in this patient’s biopsy was of an unclear aetiology, but probably indicates a perforation of the bowel. Any cause of bowel perforation adjacent to the adnexa can lead to TOA, therefore providing a rational speculation for this case.

  • pathology
  • reproductive medicine

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  • CMV and EM contributed equally.

  • Contributors CMV conducted chart and literature review, met with the pathologist to review tissue specimens and discuss the findings in more detail, and helped write, revise and assemble the figures for the case report. EM initiated the planning along with SY, oversaw the chart and literature review, and reviewed and edited the case report for submission. SY initiated the planning along with EM, and reviewed and edited the case report for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed

  • Patient consent for publication Obtained.