A rare case of Melanosis peritonei development after rupture of ovarian teratoma = A rare case of Melanosis peritonei development after rupture of ovarian teratoma

다국어 초록 (Multilingual Abstract)

Melanosis peritonei is a very rare benign disease in the peritoneum. Visually, dark brown pigmentation is widespread in the peritoneum, and it looks like an endometriosis lesion or metastastic melanosis. The pathogenesis of the causes of pigment-producing cells is unclear, but the most accepted hypothesis among them is that it is caused by spillage of pigment in ruptured ovarian teratoma. Supporting this hypothesis, we would like to introduce a case in which peritoneal melanoma was found in three surgeries over time. A 32-year-old female patient came to the outpatient department of gynecology at the hospital because of persistent complaints of pelvic pain. The patient had a mature cystic teratoma in the left ovary 6 years ago, and laparoscopic left ovarian cystectomy was performed. At that time, the peritoneum was clear and there were no other findings. Two years ago, there was a recurrence of a mature cystic teratoma of 2.5 cm in the right ovary and 2.5 cm in the left ovary, thus a second surgery was decided. On laparoscopy, omentum and intra-abdominal adhesions were present, and intraperitoneal pigmentation was seen. And about 6 months ago. There were no specific findings on follow-up on ultrasound and CT, but the patient complained of persistent pelvic pain and pain extending to the lower extremities, so a third diagnostic laparoscopic surgery was decided. There was extensive pigmentation and adhesions around the omentum and peritoneum, both ovaries and fallopian tubes. The final pathological finding was peritoneal inclusion cyst with focal aggregation of pigment-laden macrophages (consistent with melanosis peritonei). At first glance, it did not look much different from the endometriosis lesion, but the pathological finding was melanosis peritonei. It is considered an important case for inferring the cause and etiology of the very rare disease Melanosis peritonei.