Presentation
Irregular menses.
Patient Data
Two right ovarian cystic lesions with heterogeneous content showing high T1 and T2 signal with partial signal suppression on T1 fat sat sequence reflecting fat content. No enhancing component is identified. No mural or internal enhancing component is identified. Internal diffusion restriction is noted. The smaller posterior cyst shows a fat-fluid level.
The left ovary shows T2 hypointense stroma and peripherally arranged follicles, suggestive of polycystic ovarian morphology.
The uterus shows two small posterior wall interstitial fibroids.
Case Discussion
The presence of a fat signal in an ovarian cyst is usually sufficient to make a diagnosis of mature cystic teratoma. The presence of diffusion restriction in cyst content is thought to be due to the presence of keratin which restricts Brownian movement of water molecules 1.
The presence of diffusion restriction in the cyst wall reflects hypercellularity that raises the suspicion of malignant transformation, which occurs in about 1% of cases, usually in elderly patients 1.
Unable to process the form. Check for errors and try again.