Abstract
Ovarian cysts and specifically ovarian teratomas are a common finding in young patients. These cysts display histological cell types from all three cells lines: endodermal, ectodermal and mesodermal origins. A 22-year-old woman who displayed classic signs of cortisol excess - excessive weight gain, difficultly losing weight and abdominal striae - was found to have a 10 cm mature teratoma cyst. This patient presented with ovarian torsion, a common complication of ovarian cysts, and was treated surgically. Pathology was significant for an ovarian teratoma with pituitary secreting cells, most significantly cells secreting adrenocorticotropic hormone (ACTH).