PMC9890218_01
Imaging studies of the pelvis. (A) Transvaginal ultrasound image showing a right ovarian cyst (left arrow) and a left ovarian cyst (right arrow). (B) Axial T2-weighted MRI showing a right ovarian cyst (arrow). (C) Axial T2-weighted MRI showing a left ovarian cyst (arrow).
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Transvaginal ultrasonography revealed a 3-4-cm diameter mass on each ovary (Fig. 1A) and a normal-sized uterus. Magnetic resonance imaging (MRI) revealed bilateral ovarian cystic tumors with fat tissue (Fig. 1B and C).
Laparoscopic views and pathological findings. (A) Single-port system for laparoscopic viewing: Lap Disc Mini  (Hakko Corporation, Osaka, Japan) and EZ Access  (Hakko Corporation). (B-1) The uterus, which is normal-sized, and the ovaries, which are swollen because of the presence of teratomas. (B-2) Omental tumor, resembling a teratoma.
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To use the conventional laparoscopic atraumatic grasping forceps, two 5-mm trocars were inserted through the Lap Disc Mini  (Fig. 2A). Bilateral ovarian mature cystic teratomas and an omental tumor that was macroscopically similar to the ovarian teratomas were discovered intraoperatively (Fig. 2B-1 and B-2).
Pathological findings: right ovarian cyst (A), left ovarian cyst (B) and tumor in the greater omentum (C). (A, B) Ectodermal derivatives including the central nervous tissue and mesodermal derivatives including cartilage and adipose tissue in the ovarian tumor. (C) Ectodermal derivatives including squamous epithelium, respiratory epithelium and goblet cells were observed in the omental tumor.
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The omental tumor contained ectodermal derivatives such as squamous epithelium, respiratory epithelium and goblet cells (Fig. 3).