IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Floating balls sign in mature cystic ovarian teratoma

Case contributed by Alaoui Belhassan Mamoun
Diagnosis almost certain

Presentation

History of abdominal bloating

Patient Data

Age: 65 years
Gender: Female

Large pelvic cystic lesion seems to be attached to left ovary, well-defined, which is the seat of small floating rounded inclusions (floating balls sign) appearing on T2 with a hyperintense center and hypointense rim, hyperintense on T1 with signal drop on T1 Fat Sat which is compatible with fat content.

We also note the presence of an intracystic septa at the lower pole centered by a nodule probably related to a protuberance of Rokitansky.

Case Discussion

The floating ball sign was described as a pathognomonic sign but rarely found in cystic ovarian mature teratoma. It is seen in patients with larger teratomas and requires the search for associated imaging signs of malignancy.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.