Mature cystic ovarian teratoma

Case contributed by Dr Antoni Boscà

Presentation

Acute severe pelvic pain and swollen abdomen. The patient also has nausea and vomiting.

Patient Data

Age: 52
Gender: Female
CT

Left ovarian mass, located anterior to the uterus, with a fat-fluid level, a central Rokitansky nodule, tufts of hair and calcification. Distended, swirling left ovarian vascular pedicle consistent with ipsilateral ovarian torsion being the cause for acute presentation.

Annotated image

Edited images showing the striking similarity between the ovarian cystic teratoma and a "Poké Ball".

Authors of this case are Drs Antoni Boscà Ramon, Marcelo Rengel, Ana Julve Parreño.

Case Discussion

The displayed ovarian mass was removed and the anatomopathological study confirmed the existence of a mature ovarian teratoma with areas of hemorrhage, along with an abundant pilous component. The patient presented with elevation of CA 125 and CA 15-3 tumor markers.

This case contains a striking example of pareidolia; a psychological phenomenon wherein a stimulus (an image in this case) is perceived to contain a familiar pattern of something (in this case a Poké Ball) where none actually exists. This phenomenom is encountered not infrequently in radiology, and in fact Radiopaedia has an article entitled Rorschach radiology which is dedicated to it! 

Aside from the pareidolia, this case is an excellent example of a mature cystic teratoma appearance on CT, and in particular it highlights how large ovarian masses can cause ovarian torsion which is a surgical emergency. 

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Case information

rID: 46899
Case created: 22nd Jul 2016
Last edited: 11th Dec 2016
System: Gynaecology
Inclusion in quiz mode: Included

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