Monodermal cystic ovarian teratoma composed of respiratory epithelium.

A 7-year-old girl reported with a lump in the lower abdomen of 3 months' duration. There was no history of abdominal pain, gastrointestinal or respiratory disturbance, or vaginal discharge. On examination, there was an intra-abdominal lump situated to the right of midline. The lump was firm and mobile, measuring 10 cm in diameter. The external genitals were normal. Routine investigations including urine, stool, blood counts, haemoglobin, bleeding and clotting times, plain X-ray of the abdomen and chest and excretory urogram were all within normal limits. Exploratory laparotomy revealed an enlarged cystic right ovary and a right salpingo-oophorectomy was carried out. There were some adhesions between the cystic tumour and surrounding pelvic structures. The left ovary, pelvic and other abdominal organs were normal. The postoperative recovery of the patient was uneventful and the patient is alive and well 18 months after. The removed specimen consisted of a cystic mass measuring 8 x 5 x 3 cm. The serosal surface was smooth and white. On cut section, the tumour revealed a multilocular cyst. No solid area was present. The entire tumour was sectioned for histological evaluations and all sections revealed the similar histological pictures. The cystic spaces were lined by well differentiated pseudostratified columnar epithelium closely resembling normal respiratory epithelium (Fig. 1). The septae were composed of fibrous connective tissue with chronic inflammatory cells. No other tissues such as neuro-ectodermal tissue, skin, skin appendages and cartilages were found. Occasional foci of residual ovarian stroma with primordial follicles were present subserously in few sections.