Ovarian teratoma as a Differential in an Upper Abdomen Lump (IJMPR Book 1)

A 40 year old woman presented with an ever-increasing lump in right upper abdomen that she was noticed after drainage of an abscess in the same region during her pregnancy 15 years back. On examination it was a smooth, globular, 10 x 8 cm size lump in right hypochondrium and lumbar region that moved with respiration and could have been mistaken for a gall bladder lump but for a well defined upper margin.
A CECT abdomen showed a 6.6x5.8x4.5 cm3 oval non enhancing soft tissue lesion having fat density and calcification adjacent to ascending colon & small bowel loops. On exploration it was found to be an ovarian cyst that was adherent to the surrounding bowel and had a long pedicle going into the pelvis. On histopathology it was reported to be a mature ovarian teratoma.