Perforated degenerated immature teratoma of the ovary: Rare cause of acute peritonitis, case report and review of the literature

Malignant transformation of ovarian teratomas is rare, provoking peritonitis and death are exceedingly rare. We present the case of a 75-year-old woman who was admitted to the emergency department for severe abdominal pain with septic shock due to acute peritonitis caused by perforation of the ovarian mass. Teratomas are germ cell tumors usually composed of multiple cell types derived from one or more of the three germ layers. Pathologically, malignant transformation of ovarian dermoid cysts is rare due to the thickness of the capsule, spontaneous rupture is a very rare complication, acute peritonitis presents with features of acute abdomen or shock, treatment is essentially surgical and includes at least unilateral adnexectomy, complete exploration of the pelvis and abdominal cavity, peritoneal washing and/or sampling of any ascites. In conclusion, although ovarian teratoma with granulomatous peritonitis is rare, rupture leading to generalised acute peritonitis further worsens the prognosis. Which will ensure correct management that will provide a good outcome with less complications. •Ovarian teratomas are tumors originating from pluripotent germ cells, 3 types of teratomas are described: mature, immature and monodermal teratoma. malignant transformation of ovarian dermoid cysts is rare less than 1%.•The rupture is a very rare complication, the possible aetiologies explained in the literature are infection, infarction or malignant transformation of the tumour, direct trauma•After rupture, the release of tumour contents may cause peritonitis, It can be acute or chronic. Acute peritonitis presents with features of acute abdomen or shock.•Treatment is essentially surgical, involving at least unilateral adnexectomy, complete exploration of the pelvis and abdominal cavity, peritoneal washing and/or sampling of any ascites.•The majority of investigators agree that more advanced tumours have a poorer prognosis, rupture leading to generalised acute peritonitis further worsens the prognosis.