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Type:
Educational Exhibit
Keywords:
Abdomen, Genital / Reproductive system female, Pelvis, CT, Ultrasound, MR, Education, Diagnostic procedure, Cysts, Education and training
Authors:
X. Codo Tarraubella1, M. J. Herraiz Bayod2, J. J. Sola Gallego2, M. A. ALCAINE CAMEO2; 126006/ES, 2Logroño/ES
DOI:
10.1594/ecr2017/C-0913
Background
Ovarian teratoma is a type of germ cell tumour.
Teratomas comprise a number of histologic types of tumors.
The mature cystic teratoma (also known as dermoid cyst) is the most common of these tumors and,
in some series,
the most common ovarian neoplasm (10-20%) of all ovarian neoplasms.
That is why it is critical to correctly identify them,
and several imaging techniques are proven helpful to reach a proper and rapid diagnosis.
Mature cystic teratoma is especially prevalent in younger age group (mean patient age,
20-30 years).
The tumors are bilateral in about 10% of cases.
Mature cystic teratomas are cystic tumors that typically contain mature tissue of at least two of three composed germ cell layers: ectodermal tissue (skin derivatives and neural tissue) is invariably present,
mesodermal tissue (fat,
bone/tooth,
cartilage,
muscle) is present in over 90% of cases and endodermal tissue (mucinous or ciliated epithelium) is seen in the majority of cases.
Adipose tissue is present in 67%–75% of cases,
and teeth are seen in 31% (figure 1).
We can visualize the distinctive combination of these elements (fat,cyst,tissue,bone) through the US,
CT and MRI images and,
in most of the cases,
it allows us to reach a confident and accurate diagnosis without need of pathological anatomy.
Mature cystic teratomas tend to be asymptomatic but can be associated with several complications with unspecific symptoms.
Ovarian torsion,
which is defined as partial or complete rotation of the ovarian vascular pedicle,
is usually associated with cyst/tumor and the most common is mature cystic teratoma.
Moreover,
ovarian torsion is the main complication of ovarian teratoma (16% of ovarian teratomas).
Due to this high frequency and the fact that it is an emergency pathology,
radiologist should be trained to rapidly diagnose it.
Other relevant,
and not forgettable complications,
are malignant transformation (1-2%) or rupture (1-4%).
Finally,
some rare complications are infection (1%) or autoimmune hemolytic anemia (<1%).