SONOWORLD : Left ovarian dermoid

Username

Password

181,723 Registered Members as of 07/13/2020.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Pelvis » Female Pelvis (Gynecology)

Left ovarian dermoid

« Back to Listing

Author(s) :

Haroon Durrani, MD

Chaitali Shah, FRCR

Presentation A 35 year old woman presented with pain in left lower abdomen of 2 months duration. There were no other associated symptoms. An ultrasound of the pelvis was performed.

Caption: Transvaginal image of the left adnexa

Description: A highly echogenic left ovarian mass is identified. The posterior margins of the mass appear obscured. Compressed normal ovarian tissue with a few follicles is seen peripherally.

Caption: Coronal image of left ovary

Description: The left ovarian mass shows a highly echogenic content characteristic of lipid deposit or calcification. There is shadowing noted from the margin of the mass, possibly representing calcification.

Differential Diagnosis Left ovarian mass – dermoid, calcified cyst, malignancy

Final Diagnosis Left ovarian dermoid

Discussion These images of an ovarain benign cystic teratoma (“dermoid”) demonstrate the classic `tip of iceberg sign`, which, according to Rumack et al, results from an echogenic dermoid mass producing ill-defined acoustic shadowing that obscures the posterior borders of the mass. This occurs due to the contents of the dermoid [matted hair and sebum] that creates a large number of small scattering reflective interfaces and hence the “dirty“ shadowing.

Case References 1. Carol Rumack, Stephanie Wilson, et al. Chapter 15-The uterus and Adnexa by Shia Salem. Diagnostic Ultrasound -Volume One.

Follow Up The left dermoid cyst was surgically confirmed.