OT are usually detected in young women; the patients' median age at diagnosis is 35 and 27 years in the case of mature cystic teratoma and immature teratoma, respectively  .
Abdominal pain is the single most important symptom of OT. Women may also experience abnormal uterine bleedings. Occasionally, OT exerts local mass effects that interfere with bladder and intestinal function. Torsion, rupture, and infection of OT are rare events, but dreaded complications causing a rapid deterioration of a patient's general condition . Of note, about one in six patients are asymptomatic. Here, OT is incidental finding diagnosed during a routine physical and gynecological examination.
Workup comprises diagnostic imaging to confirm the presence of an ovarian mass and to assess whether metastases have developed in other parts of the reproductive system, lymph nodes, or distant organs:
In order to distinguish between benign and malignant OT, measurements of serum α-1-fetoprotein, β-human chorionic gonadotropin and cancer antigen 125 (CA 125) should be performed. Enhanced concentrations of either marker are indicative of malignancy  .