Mature ovarian teratomas are the most common benign germ cell tumors of the ovary and usually affect women of reproductive age. Their clinical presentation is variable, and in some cases, imaging findings may be misleading, complicating the preoperative diagnosis. We report a case of an 18-year-old female patient who presented to the emergency department with acute abdominal pain. Imaging studies revealed a large intra-abdominal mass initially interpreted as originating from the mesentery. Due to persistent symptoms and diagnostic uncertainty, surgical exploration was performed. Intraoperatively, the mass was identified as an ovarian lesion, and complete resection was achieved. Histopathological examination unexpectedly confirmed the diagnosis of a mature cystic teratoma without malignant features. The postoperative course was favorable, and the patient recovered without complications. This case highlights the diagnostic challenges associated with atypical presentations of ovarian teratomas and underscores the importance of considering gynecologic pathology in the differential diagnosis of abdominal masses in young women, even when imaging suggests an extragonadal origin. Surgical exploration remains essential when clinical presentation involves severe symptoms or diagnostic ambiguity, allowing both definitive histopathological diagnosis and resolution of symptoms.

Techniques for abdominal wall reconstruction include the use of prosthetic materials (synthetic or biological meshes), component separation, autologous tissue reconstruction, or a combination thereof. Reconstruction using prosthetic materials avoids additional trauma to healthy tissues but carries risks such as infection, adhesion to surrounding structures, and bowel obstruction caused by intestinal adhesions. Therefore, abdominal wall reconstruction using autologous tissue may be considered as an option suitable for women of childbearing potential. Only a few cases of successful childbirth following abdominal wall reconstruction have been reported, and opportunities to reincise and directly observe the reconstructed wall are rare. No previous reports have described intraoperative findings during reincision of a previously reconstructed abdominal wall. We report the case of a 23-year-old woman who underwent abdominal wall resection for a rectus abdominis tumor secondary to an immature ovarian teratoma. We reconstructed the abdominal wall using an anterolateral thigh flap with vascularized fascia lata, including the perifascial areolar tissue. The defect was reinforced with a well-vascularized flap sutured in an inlay manner, partially in 2 layers. The patient conceived naturally after reconstruction. The reconstructed abdominal wall remained strong and flexible, accommodating expansion of the abdominal circumference during pregnancy without herniation. We reincised the reconstructed abdominal wall during cesarean section and found no adhesions to the surrounding tissues. Therefore, an anterolateral thigh flap with vascularized fascia lata and perifascial areolar tissue may represent a promising option for abdominal wall reconstruction in young women with childbearing potential.

Intracranial germ cell tumors (iGCTs) are rare central nervous system neoplasms predominantly affecting children, adolescents, and young adults. They exhibit striking geographic and gender predilection, with a higher incidence in East Asian populations and a marked male preponderance. Clinically, iGCTs encompass two broad entities-germinomatous and non-germinomatous tumors, with the latter comprising embryonal carcinoma, yolk sac tumor, choriocarcinoma, immature teratoma, and mixed germ cell histologies. This histopathological distinction has critical prognostic implications and remains the cornerstone for contemporary risk-adapted treatment strategies. Current practice relies on an interplay of serum and cerebrospinal fluid tumor markers, neuroimaging, and selective histopathological confirmation for diagnosis. However, there is a lack of a universally accepted consensus on the diagnostic work-up and management protocols for such tumors owing to their infrequent incidence and divergent cooperative group philosophies. Substantial discordance persists in tumor marker thresholds, indications for biopsy, staging definitions, radiotherapy planning, and the role of neoadjuvant chemotherapy. In this context, we did an intensive literature search for relevant articles on iGCTs over PubMed, Embase, and Google Scholar search engines and formulated the present review, which critically integrates contemporary evidence and major international guidelines, including those from European Oncology Societies (EANO-SNO-EURACAN), the Children's Oncology Group (COG), the International Society of Pediatric Oncology (SIOP), and the Japanese Society of Neuro-Oncology (JSNO), to provide a comprehensive overview of epidemiology, biology, diagnostic paradigms, risk stratification, and multimodality management of iGCTs.

A dermoid cyst, also called a benign cystic teratoma, often presents as a midline mass in the trunk or sacrococcygeal region, and more commonly in the skin of the face, forehead, and scalp. Although the ischiorectal fossa contains very few structures, a wide variety of pathological entities, such as developmental cysts, epidermoid cysts, lipomas, neurofibromas, and tailgut cysts, have been reported. Dermoid cysts in the ischiorectal fossa are rare, and very few cases have been reported in the scientific literature. This case report presents an uncommon presentation of a dermoid cyst in the ischiorectal fossa in a 25-year-old female patient.

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by vasogenic edema, predominantly involving the posterior regions of the brain, and can be triggered by various conditions. PRES has rarely been reported in patients with autoimmune encephalitis, and no cases have been reported in anti-N-methyl-ᴅ-aspartate receptor (NMDAR) encephalitis before the initiation of immunotherapy. We report a case of a 36-year-old woman who presented with recurrent seizures and severe hypertension, with brain magnetic resonance imaging showing subcortical fluid-attenuated inversion recovery hyperintensities in both occipital regions, consistent with PRES. Blood pressure control and antiseizure medication therapy markedly reduced seizure frequency and resulted in near-complete resolution of the occipital lesions; however, occasional brief seizures continued, and psychomotor slowing and gait disturbance persisted despite sustained blood pressure control. Further evaluation revealed anti-NMDAR antibodies in both serum and cerebrospinal fluid and a small mature teratoma in the right ovary. She received corticosteroid immunotherapy, followed by laparoscopic ovarian cystectomy, and achieved complete neurological recovery. Notably, brain lesions consistent with PRES were present at disease onset, excluding immunotherapy as a potential cause. Severe hypertension likely played a major role in the development of PRES, and autonomic instability associated with anti-NMDAR encephalitis may have contributed to blood pressure dysregulation. Immune-mediated endothelial dysfunction and recurrent seizures may also have contributed to the development of the occipital lesions. This case expands the radiological spectrum of anti-NMDAR encephalitis and highlights the importance of considering autoimmune encephalitis in patients with PRES, particularly when there is no apparent precipitating factor or the clinical course is atypical.

In colorectal cancer, the invasion of the colon is not unusual, but the perforation of all layers of the colon or rectum and the presentation of the patient with generalized peritonitis is rare. Colo-ovarian fistulas have as their starting point either in the sigmoid colon, rectum, appendix or, more frequently, as a benign or malignant ovarian tumor. The present study reports an extremely rare case of colorectal cancer with perforation at the rectosigmoid junction into a metastatic ovarian tumor. Intraoperatively, a colo-ovarian fistula with diffuse peritonitis was diagnosed. The treatment consisted of a hysterectomy with bilateral salpingo-oophorectomy, and the resection of the colo-ovarian fistula was performed using the Hartmann procedure. The prognosis was poor due to the advanced stage of colorectal cancer and complications from peritonitis. Due to the rarity of this pathology, an extensive electronic search and an analytical review of studies published in the PubMed and Web of Science databases was performed, identifying 21 eligible studies on malignant colo-ovarian fistula (11 cases due to advanced stages of primary ovarian cancer and 10 cases of malignant transformation of cystic teratoma) and no case in which the primary tumor was of colorectal origin. Based on the literature review, the current case report aimed to obtain and present a better understanding of the pathology, differential diagnosis, therapeutic strategy and prognosis of the condition.