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Mature cystic teratoma

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Abdominal x-ray for pain and diarrhea, diagnosis of ulcerative colitis made. A few months later, has a CT scan following subtotal colectomy and end ileostomy formation, because of pyrexia and wound discharge.

Patient Data

Age: 30 years
Gender: Female
x-ray

Tooth-like calcification is present just to the right of the midline in the pelvis. This is suspicious for a mature cystic teratoma (dermoid cyst). No bowel abnormalities.

Endoscopy and biopsy confirmed ulcerative colitis, with symptoms refractory to maximal medical therapy. Surgery was planned.

ct

Post-operative CT following subtotal colectomy and formation of end ileostomy. A small volume fo free fluid is present, along with inflammation of the residual colon. 

6 cm cystic structure in pelvis with fat and tooth density within, confirming diagnosis of mature cystic ovarian teratoma.

Case Discussion

Mature cystic ovarian teratomas (dermoid cysts) are slow growing ovarian tumors composed of derivatives of the germ cell layers: ectoderm, mesoderm, and endoderm. Therefore they can contain variable amounts of hair, fat, skin, teeth and bone.

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