The combination of ovary and tubal teratoma is exceptionally uncommon, in fact only a handful of cases have been reported in literature. In this case report we would like to not only illustrate a tubo-ovarian mature teratoma in a pre-menopausal woman, but also elucidate our pre-operative diagnostic approach, utilizing ultrasound (US) first and magnetic resonance imaging (MRI) after. In literature, no study on tubal teratoma has concentrated on the diagnostic work-flow to correctly characterize and identify the origin of the neoformation, necessary to reach a comfortable diagnosis prior to surgery. As a matter of fact, tubarian teratomas have been diagnosed either by chance during routinary transvaginal ultrasound (TVUS) examinations, or incidentally during surgical procedures and subsequently confirmed by histopathological analysis. Differently from what previously recounted in other papers on tubal teratoma focusing more on the surgical aspects, this is the first case-report providing detailed MR diagnostic image findings, that could help other doctors whenever encountering such an ambiguous tumor. Our aim was to culminate this gap: we dedicated time to comprehensively characterize, classify and identify the origin of the lesion exclusively through diagnostic images, and route the diagnosis to a very probable ovary-tubaric teratoma, thus facilitating the surgical planning.

Keywords: Tubo-ovarian; Teratoma; Magnetic resonance imaging; Laparoscopy; Case report; Teratoma images; Pathology