Sack of marbles sign (dermoid cyst)
Citation, DOI, disclosures and article data
Citation:
Khader.O.Thabet M, Saber M, Haouimi A, et al. Sack of marbles sign (dermoid cyst). Reference article, Radiopaedia.org (Accessed on 09 Mar 2025) https://doi.org/10.53347/rID-56924
Permalink:
rID:
56924
Article created:
2 Dec 2017,
Mohammed Al Khader.O.Thabet
Disclosures:
At the time the article was created Mohammed Al Khader.O.Thabet had no recorded disclosures.
View Mohammed Al Khader.O.Thabet's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Mohamed Saber had no recorded disclosures.
View Mohamed Saber's current disclosures
Revisions:
10 times, by
7 contributors -
see full revision history and disclosures
Systems:
Sections:
Synonyms:
- Marbles in a bag sign
The sack of marbles sign, also known as the marbles in a bag sign, refers to aggregations of multiple small globules of fat within a cyst mimicking marble spheres within a sack. They appear hyperechoic on ultrasound, fat attenuation on CT, and high signal on T1WI and T2WI on MRI. It is considered highly suggestive of a dermoid cyst in the head and neck region 1-7. The term has also been used to describe ovarian dermoid cysts 8,9, although the floating balls sign is a more commonly used descriptor in this region.
References
- 1. Koeller KK, Alamo L, Adair CF, Smirniotopoulos JG. Congenital cystic masses of the neck: radiologic-pathologic correlation. Radiographics : a review publication of the Radiological Society of North America, Inc. 19 (1): 121-46; quiz 152-3. doi:10.1148/radiographics.19.1.g99ja06121 - Pubmed
- 2. Mammen S, Korulla A, Paul MJ. An epidermal cyst in the floor of the mouth: a rare presentation. Journal of clinical and diagnostic research : JCDR. 7 (2): 381-2. doi:10.7860/JCDR/2013/4165.2776 - Pubmed
- 3. Mirza S, Fadl S, Napaki S, Abualruz A. Case report of complicated epidermoid cyst of the floor of the mouth: Radiology-histopathology correlation. (2014) Qatar medical journal. 2014 (1): 12-6. doi:10.5339/qmj.2014.2 - Pubmed
- 4. Lin HW, Silver AL, Cunnane ME, Sadow PM, Kieff DA. Lateral dermoid cyst of the floor of mouth: unusual radiologic and pathologic findings. (2011) Auris, nasus, larynx. 38 (5): 650-3. doi:10.1016/j.anl.2011.01.002 - Pubmed
- 5. Giarraputo L, Savastano S, D'Amore E, Baciliero U. Dermoid Cyst of the Floor of the Mouth: Diagnostic Imaging Findings. (2018) Cureus. 10 (4): e2403. doi:10.7759/cureus.2403 - Pubmed
- 6. Otonari-Yamamoto M, Nakajima K, Sakamoto J, et al. Atypical MRI and Histopathological Findings in Dermoid Cyst. (2018) The Bulletin of Tokyo Dental College. 59 (3): 207-212. doi:10.2209/tdcpublication.2017-0044 - Pubmed
- 7. Fujimoto N, Fujii N, Nagata Y, et al. Dermoid cyst with magnetic resonance image of sack-of-marbles. (2008) The British journal of dermatology. 158 (2): 415-7. doi:10.1111/j.1365-2133.2007.08321.x - Pubmed
- 8. Wang A, Shu Y. Mature ovarian cystic teratoma with "sack of marbles" appearance on magnetic resonance imaging: A case report. (2019) Medicine. 98 (31): e16691. doi:10.1097/MD.0000000000016691 - Pubmed
- 9. Lee KH. 'Sack of marbles' in mature cystic ovarian teratoma. (2017) Abdominal radiology (New York). 42 (5): 1616-1617. doi:10.1007/s00261-017-1059-x - Pubmed
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