Presentation
Severe right renal colic
Patient Data
Tooth-like transversely oriented calcification in the right pelvis. Subtle rounded lucency inferior to the calcification. Fecal loading of the colon but no dilatation of bowel loops. Normal bones.
Well circumscribed right ovarian mass containing fat, soft tissue density and a single dentiform calculus, in keeping with a mature cystic ovarian teratoma.
The mass compresses the distal third right ureter resulting in mild upstream hydroureter but no hydronephrosis. No calculi along the renal tract.
Case Discussion
Mature cystic teratomas are benign tumors of the ovary composed of mature tissue representing at least two embryonic layers (ectoderm, mesoderm or endoderm) 1. They are commonly seen in young women, with mean age of 30 years 2.
Most are asymptomatic unless a complication develops, such as torsion, rupture or malignant transformation 2. In this particular case, the calcification mimicked a renal calculus on abdominal radiography but the orientation of the long axis was atypical, while the dentiform morphology suggested a teratoma. The mass caused mild hydroureter from extrinsic compression of the distal ureter. The presence of fat confirmed on CT clinched the diagnosis.
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