Atypical Presentation of Giant Unilateral Mature Cystic Teratoma with Bilateral Involvement in an Adolescent Patient: A Case Report

Introduction: Mature cystic teratomas are common germ cell tumors in young women and usually present as benign adnexal masses; however, they may present atypically and reach giant dimensions. Case presentation: We present the case of a 17-year-old female patient with an atypical clinical presentation characterized by chest pain radiating to the pelvic region and sensation of an abdominal mass. Imaging studies revealed bilateral adnexal tumors, one of them of giant size, with features compatible with mature cystic teratoma. Tumor markers were within normal ranges. Exploratory laparotomy was performed with right salpingo-oophorectomy and resection of the teratoma in the left ovary with preservation of ovarian tissue. The diagnosis was confirmed by histopathological examination. The patient had a favorable postoperative course, without complications and with adequate clinical recovery. Conclusion: This case highlights the atypical presentation, giant growth, and bilaterality of mature cystic teratomas, as well as the importance of a comprehensive diagnostic approach and individualized surgical management focused on fertility preservation in young patients.