Mature cystic teratoma: recognize typical signs in the ultrasonography
Number:27ESURABS0091
Type:Scientific Electronic Presentation
Authors: Carolina Zaghini, Beatriz Ahmad, Bruno Pasquini, Ricardo Azze Natel, Priscila Falsarella, Victor Jabour, Antonio Rahal Junior
Keywords:Teratoma; Ultrasonography; Doppler Ultrasonography; Dermoid Cyst; Ovarian Torsion
SECTIONS
Objectives

The aim of this project is to describe mature cystic teratoma and recognize common findings in imaging exams such as ultrasound.


Material and methods

For the case report were used datas collected by the medical team, information from the medical record and image exams requested.

A 30-year-old woman with severe acute left pelvic pain for 2 days. A transvaginal ultrasonography (US) was requested for diagnostic investigation and showed the uterus and the right ovary without changes. On the other hand, the left ovary was cranially displaced in the hypogastrium, with increased dimensions and presenting a heterogeneous nodular lesion (about 10.0 cm), which showed a hyperechogenic component with linear areas, calcifications and a cystic area in between.

Even with the US already suggesting the probable diagnosis, a computed tomography scan of the abdomen was requested for confirmation. A left adnexal lesion was observed, in correspondence with the US, measuring approximately 10.0 cm and with a fatty component, gross...

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Left ovary displaced cranially in the hypogastrium, with increased dimensions, presenting a heterogeneous nodular lesion, which presents a hyperechogenic component with linear areas, calcifications and a cystic area in between.
In this axial section of the pelvis, a left adnexal lesion was observed, corresponding to the USG, measuring approximately 10.0 cm in its longest axis. With a fatty component, gross calcifications and cystic area in between.

Results

Mature cystic teratoma or dermoid cyst is a congenital cystic tumor composed of differentiated derivatives of at least two of the three layers of germ cells, being predominant elements of the ectoderm. It accounts for 95% of ovarian teratomas. It usually occurs in women of fertile age. The procedure can be performed by surgical excision with preservation of part of the ovary, and when the teratoma is not complicated, smaller than 6 cm and with slow growth, it is only followed up. Possible complications are: ovarian torsion, rupture and adhesion, infection, autoimmune hemolytic anemia and malignant degeneration. Differential diagnoses are endometrioma, hemorrhagic cyst, pedunculated lipoleiomyoma and ovarian cancer.

Regarding the teratoma US analysis, it is possible to observe some typical signs, such as the dermoid plug or Rokitansky nodule (a predominantly cystic mass with an...

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Conclusions

It is important to know the histological variations of dermoid cyst and to recognize the typical signs and confusing images in the US. The clinical suspicion of teratoma should be thoroughly investigated during US because it can simulate an intestinal loop with air inside it and compromises the diagnosis.