Fistula formation after excision of extraperitoneal paravaginal teratoma

Taiwan J Obstet Gynecol. 2025 Jan;64(1):151-154. doi: 10.1016/j.tjog.2023.10.018.

Abstract

Objective: Mature extragonadal teratomas, particularly at the pelvic extraperitoneal site, are rare. Herein, we report a case of paravaginal teratoma and fistula formation five years post-operation.

Case report: A 23-year-old woman (G4P3A1) presented with a left paravaginal cystic tumor. After transvaginal tumor excision, histopathology revealed a paravaginal dermoid cyst. Five years post-operation, she returned with recurrent symptoms, including fever and perineal pain. Pelvic magnetic resonance imaging showed abscess at the surgical site, with tract-like extensions through the levator ani and vaginal wall. Treatment was administered without surgical intervention. Seven years post-operation, the patient underwent debridement of the left paravaginal abscess via the left perineal route. The patient was diagnosed with an abscess and an epidermal keratinous cyst with a vaginoperineal fistula. No recurrent abscess or fistula formation was encountered four years after debridement and fistulectomy.

Conclusion: Preoperative and postoperative counseling should be conducted with long-term follow-up for such patients.

Keywords: Mature extragonadal teratoma; Paravaginal fistula; The Hounsfield unit value of computed tomography.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / etiology
  • Abscess / surgery
  • Debridement
  • Dermoid Cyst / surgery
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Teratoma* / diagnostic imaging
  • Teratoma* / surgery
  • Vaginal Fistula / etiology
  • Vaginal Fistula / surgery
  • Vaginal Neoplasms / surgery
  • Young Adult