Immature ovarian teratoma
Lower abdominal pain
CT abdomen with contrast
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A sizeable pelvi-abdominal adnexal multilocular complex cystic lesion measuring about 12 x 18 x 23 cm in its largest AP, side to side and cephalo-caudal dimensions, respectively. It has a heterogeneous matrix; mainly cystic with multiple enhancing septa of variable thickness, multiple intralesional soft tissue nodules, scattered fat components and calcific elements. The lesion exerts mass effect in the form of displacement of bowel loops laterally and compression upon the urinary bladder.
Mild free ascites seen at the right peri-hepatic space and pouch of Douglas.
Immature ovarian teratoma represents less than 1% of ovarian teratomas. It is an uncommon ovarian germ cell tumor, which differs from the far more common mature ovarian teratomas (dermoid cysts). It is usually seen in young females, as in this example. It appears on CT as a large cystic lesion with solid components that shows coarse calcifications and streaks of fat