“ Most common germ cell tumour of the ovary. An age of 30 years is typical at diagnosis . Most are asymptomatic. Dermoids grow slowly and, i...
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Most common germ cell tumour of the ovary. An age of 30 years is typical at diagnosis. Most are asymptomatic. Dermoids grow slowly and, if less than 6 cm, non-surgical management is preferred. It is a thickwalled cyst containing fat and the three germ layers (the Rokitansky nodule). Dermoid cysts may rupture or cause ovarian torsion (higher risk if large). Small malignant potential.
US
• Variable appearance from solid to cystic, depending on the contents of the dermoid
PLAIN FILM
• Tooth-shaped focus of calcification projected over the pelvis—classic
CT
• Fat-containing lesion is diagnostic, may also see calcification (e.g. tooth).
• Solid components may enhance.
• Look for a thick-walled tube and uterus deviating towards the affected side in suspected torsion.
MRI
• Signal loss on fat-suppressed sequences/out-of-phase imaging
• Restriction of diffusion on diffusion-weighted imaging.
(a) Post-contrast axial computed tomography scan of the pelvis showing a lesion in the inferior pelvis (white arrow) containing fat and enhancing soft tissue components. The tooth-shaped focus of calcification is characteristic of a dermoid cyst. (b) A follow-up computed tomography scan shows the dermoid to have ruptured. The dermoid has decreased in size and there is now free fluid (white arrow) and free fatty locules (asterisk).
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