Safety and efficacy of laparoscopic oophorocystectomy for ovarian dermoid cyst associated with autoimmune hemolytic anemia

Ovarian dermoid cysts (ODCs) are the most common benign tumors in young women, but autoimmune hemolytic anemia (AIHA) induced by ODC is rare. We report the first case of ODC-associated AIHA with improvement after laparoscopic oophorocystectomy. An 18-year-old nulliparous woman was diagnosed with a left ODC that was 7 cm in diameter. Preoperative blood tests showed macrocytic anemia, reticulocytosis, high serum lactate dehydrogenase activity, hyperbilirubinemia, and low haptoglobin. Direct and indirect Coombs tests were positive. We diagnosed AIHA. Prednisolone therapy did not result in improvement, so it seemed that AIHA was being induced by the ODC. After laparoscopic oophorocystectomy, the patient's condition improved without blood transfusion. Resection of ODC should be performed first for ODC-associated AIHA; laparoscopic surgery may be superior to laparotomy from the standpoint of hemorrhage given the underlying anemia.