Large ovarian dermoid cyst

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Abdominal distension with discomfort.

Patient Data

Age: 25 years
Gender: Female
ultrasound

Large well-defined cystic mass arising from the left ovary, containing foci of calcification surrounded by an echogenic soft tissue component (Rokitansky nodule) as well as a long echogenic line (dot-dash pattern).

mri

There is a large well-defined oval-shaped complex cystic mass arising from the left ovary measuring 14 x 11 x 8 cm. The main component is of low signal on T1 and high signal on T2 with no restricted diffusion (fluid component), containing a Rokitansky nodule composed of foci of calcification with surrounding enhancing soft tissue component. The fatty component is of right posterolateral location attenuated on fat sat sequences. 

Anteverted retroflexed uterus.

Normal appearance of the right ovary containing small follicles.

Case Discussion

The ultrasound and MRI features are most consistent with a large ovarian cystic dermoid cyst.

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