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With the increased use and quality of ultrasound in pregnancy, adnexal masses are being encountered with greater frequency. Most of the time such masses are asymptomatic. It can be discovered in an emergency. Surgical intervention may cause risks to the mother and her fetus, while observation without intervention may also lead to unfavorable complications, such as ovarian torsion or the development of a tumor. Therefore, the management requires a balance between the maternal and fetal risks. We report two cases of torsion of adnexal masses during pregnancy, and we provide a brief literature review on the management and prognosis of this condition in pregnancy.

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Mature ovarian teratomas or dermoid cysts are the most common ovarian germinal tumors and account for 20 to 25% of ovarian organ tumors. The malignant transformation of a mature teratoma is a rare event (1 to 3%), mainly found in the post-menopausal period. This is carcinomatous degeneration (80% of cases) or sarcomatous differentiated tissues of the dermoid cyst. The diagnosis of certainty is established by anatomopathological study of the surgical piece. Treatment of carcinoma teratomas is surgical and same to ovarian malignant epithelial tumors. We report four cases we managed in our health care center with a review of the literature.