Mature Cystic Ovarian Teratoma: A key topic for the FRCR 2A

Mature Cystic Ovarian Teratoma

Most common in young women under the age of 30

Can be bilateral (25%)

Can rupture - leading to a chemical peritonitis

US

Diffusely or partially echogenic cystic mass

Posterior acoustic attenuation secondary to sebaceous material, teeth and hair

Hyperechoic solid mural nodule ( Rokitiansky nodule /dermoid plug)

Thin, echogenic mesh caused by the hair in the cyst cavity: the dot-dash pattern (dermoid mesh)

No internal vascularity

Septations (10%)

CT

Areas of fat

Calcification

Fat/Fluid levels

Dermoid plug / Rokitiansky nodule - Solid hyperdensity projecting from an ovarian cyst

MRI

T1 hyperintense (due to blood)

T2 hyperintense

Fat sat

- Dark - due to suppression

Gradient echo

- May demonstrate drop out due to calcification