Abstract:

We report a rare case of an ipsilateral ovarian endometrioma occurring after surgery for a mature teratoma in an adolescent. The patient was 12 years old. At the age of 11, she underwent laparoscopic cystectomy for a left ovarian mature teratoma. Menarche occurred two months postoperatively. One year and 8 months later, she presented with abdominal pain. Re-examination revealed a new cystic mass in the ipsilateral ovary. Laparoscopic exploration showed dense adhesions between the left adnexa and the omentum/intestinal serosa, as well as a cystic mass of the left ovary. The postoperative pathological diagnosis confirmed an ovarian endometrioma. No typical endometriotic lesions were identified elsewhere in the pelvis. Postoperative management involved a six-month course of a short-term combined oral contraceptive, and no recurrence has been detected during a follow-up period of 1 year and 10 months. This case suggests that the localized adhesive microenvironment caused by ovarian surgery, possibly in synergy with early postoperative menarche, may contribute to the localized development of an endometrioma in the ipsilateral ovary. For adolescent females with a history of ovarian surgery, endometriosis should be included in the differential diagnosis for postoperative pelvic masses. Furthermore, emphasis should be placed on intraoperative adhesion prevention and long-term postoperative physical and psychological management.

Key words: Endometriosis, Puberty, Ovarian neoplasms, Teratoma, Postoperative complications