Presentation
Fall at home. Left upper quadrant pain. Splenic or renal injury ?
Patient Data
Liver, gallbladder, adrenal glands, spleen, kidneys, and pancreas all have a normal appearance. Bowel is unremarkable. Distended bladder. No free fluid or free gas. No lymphadenopathy.
Complex lesion in the left lower quadrant measures 9.3 x 12.1 x 12.0 cm in maximal dimension. It exerts positive mass effect on the distended bladder and appears adnexal in origin and a normal left ovary is not identified. It consists of numerous discrete encapsulated structures of varying size with densities ranging between fluid to fat with multiple foci of calcification and only a small solid component. The right adnexa is also enlarged measuring 4 x 2.4 cm with a more discrete hypodensity posteriorly.
Lung bases are clear. Sclerotic focus in the right femoral head is likely bone island. Old left posterior eighth rib fracture. No acute bony injury demonstrated.
Conclusion:
No traumatic injury identified. Incidental large left lower quadrant mass has characteristics of a mature (cystic) ovarian teratoma.
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