IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 9 Ver. 10 (September. 2018), PP 19-21 www.iosrjournals.org DOI: 10.9790/0853-1709101921 www.iosrjournals.org 19 | Page Left Tubal Molar Ectopic Gestation Along With Right Dermoid Cyst Ovary: A Case Report Dr Mohanvir Kaur, Dr Amitoj Sandhu, Dr Chetan Das, Dr Ninder Mall, Dr Surinder Kaur, Dr Medhavi Dhir Corresponding Author: Dr Amitoj Sandhu Abstract: The incidence of hydatidiform moles is 1 per 1,000 pregnancies. Ectopic pregnancy occurs in 20 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. Hydatidiform moles are abnormal gestations characterized by the presence of hydropic changes affecting some or all of the placental villi. Hydatidiform moles arise as a result of the fertilization of an abnormal ovum. A dermoid cyst (also called as “mature teratoma”) is a sac-like growth that may be present at birth. It contains structures such as hair, fluid, teeth or skin glands that can be found on or in the skin. In some cases, especially when in the ovary, it also contains thyroid or brain tissue. Mature cystic teratomas account for 10–20% of all ovarian neoplasms and are the most common neoplasm in younger patients.It may be complicated by torsion, rupture, chemical peritonitis and malignant change but is rarely complicated by infection. In this report the patient is a 35 year old female who presented with lower pain abdomen and bleeding per vagina since 3 days. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 10-09-2018 Date of acceptance: 27-09-2018 -------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Hydatidiform moles are abnormal gestation characterized by the presence of hydropic changes affecting some or all of the placental villi. Hydatidiform moles arise as a result of fertilization of an abnormal ovum of which the majority originate within the uterine cavity. The occurrence of a hydatidiform mole within ectopic gestational tissue is rare (1) .There are two types of HM: complete or partial, and these differentiate based on clinical presentation, chromosomal pattern, histology, and outcome. Partial HM, as with our case, occurs when the ovum is fertilized by either two sperm or one diploid sperm causing a triploid mole (69XXX, 69XXY, or 69XYY) (2) .While ectopic pregnancy and molar pregnancy are not rare events, the combination of the two, an ectopic HM, is an extremely rare event. There have only been a small number of molar ectopic pregnancies reported in the literature with estimates of incidence being around 1.5 in every 1,000,000 pregnancies (3) . Cystic teratomas make up approximately 15-25% of ovarian neoplasms. Almost 10-15% are bilateral. They are composed of well-differentiated derivatives of three germ layers-ectoderm, mesoderm and endoderm (4) .Teratomas are classified as either mature or immature types and are often composed of multiple embryologic layers. While the mature type is benign, the immature type is benign with a more aggressive course (5) . Case Report The patient was a 35-year-old female who was referred to Gynecological Department, Rajindra Hospital, Government Medical College, Patiala with the complaint of pain abdomen and bleeding per vagina for 3 days. Her gynecologic history was unremarkable. The patient underwent ultrasonography. An ill-defined heterogenous hyperechoic lesion measuring 29.5x31.2 mm in left adnexa was observed suggestive of ectopic pregnancy. Gross Features Sample A labelled as left fallopian tube with gestational sac – Received a greyish white soft tissue piece with cystic area measuring 2.5x2.5cm. Cystic area has friable exterior surface. On cutting clear fluid came out. Hemorrhagic areas seen. Sample B labelled as right fallopian tube with dermoid cyst – Received an already cut open globular soft tissue piece measuring 4 cm x 3 cm. Cheesy, yellowish white material with hair present inside the cut open cyst and also in the container was seen. The cyst has smooth outer and inner surface. On the inner safe a solid bony hard area identified measuring 1x1 cm. The surface of the bony area showed skin covering with hair follicles. Tube like structure measuring 1 cm in length recovered separately from the container.