The Incidental Dermoid: A Rare Cause of Small Bowel Obstruction in a Patient With Simultaneous Renal Cell Carcinoma

Benign ovarian dermoids are a common incidental finding in adult women. Presentation with small bowel obstruction (SBO) is rare and creates diagnostic uncertainty. Here, we describe the case of a 69-year-old lady with small bowel obstruction, who was incidentally diagnosed with a right adnexal mass and right renal mass on imaging. The correlation between bowel obstruction and the adnexal mass was unknown until laparotomy, which showed dense adhesions between the ileal loops and the adnexal mass. Following the creation of a temporary loop ileostomy, definitive management was done four months later and included adhesiolysis, right oophorectomy, and right nephrectomy. Postoperative histology revealed an inflamed and ulcerated mature cystic teratoma of the ovary, which was the cause of the patient's symptoms, and a renal cell carcinoma of the right kidney. With the universal application of cross-sectional imaging, the knowledge of such unusual associations can help surgeons decipher the occasional clinical relevance of incidentalomas. Additionally, to the best of our knowledge, this is the first documentation of a renal cell carcinoma synchronous with a benign ovarian dermoid cyst.