From syncope episode to the diagnosis of ovarian dermoid cyst associated with a cystadenoma

Ovarian teratoma has various presentations. we present a 28-year female diagnosed with a tumour after a fainting episode. medical history was non-contributory except for mild intermittent pelvic pain. cardiologic and neurological evaluation found no cause of syncope. abdominal ultrasound revealed a right ovarian tumour that was laparoscopically removed. the menses continued to be normal. the pathological exam showed an encapsulated tumour of 8 cm with hair and small bone parts (mature teratoma with a cystadenoma). immunohistochemistry was positive for ck34beta e12 in stratified squamous epithelium of skin glands; positive ck7 in kidney tubular parts; positive actin in smooth muscle. the endocrine profile was normal and the patient remained asymptomatic. the challenging in the pathological report was to differentiate a cystic part of a solid tumour to a teratoma associated cystadenoma. no apparent cause of syncope was found so a possible tumour related local pain and inflammation mechanism might be involved. © 2016,university of economics - prague. all reserved.