What happens if a benign cystic teratoma twists or ruptures?

When a benign cystic teratoma twists or ruptures, the usual consequence is the onset of acute pain. This is attributed to the sudden interruption of blood supply and the resultant inflammation or irritation of the surrounding tissue. Twisting, known as torsion, can lead to ischemia of the tumor, causing severe discomfort and necessitating management, often surgical intervention, to alleviate pain and prevent complications.

Rupture of the teratoma not only causes immediate acute pain but may also result in further complications, such as peritonitis or the release of cyst contents into the abdominal cavity, which can exacerbate the pain and lead to additional clinical concerns.

The other options do not accurately reflect the clinical reality following torsion or rupture of a benign cystic teratoma. Malignancy (the transformation into a malignant tumor) is not a direct consequence of such events; these tumors are typically benign unless there is a specific indication otherwise. Additionally, while some benign cystic teratomas can resolve spontaneously over time, the acute nature of symptoms resulting from torsion or rupture requires treatment. Lastly, it is unlikely that no symptoms would be experienced in these situations, as the sudden and severe pain is a hallmark feature.