Ovarian dermoid

Case contributed by Dr Manish Jaiswal


Abdominal lump for 1 year.

Patient Data

Age: 35 years
Gender: Female

Ultrasound images showing a large well-defined heterogeneous cystic lesion extending from right adnexa up to the level of umbilicus with fluid content, echogenic stripes, area of dense shadowing and a focus of possible tooth/ossification within.


CT abdomen of the same patient showing a large cystic lesion arising from right adnexa, containing areas of fat and fluid attenuation, foci of fat-fluid levels, ossification and a tooth-like structure as well within.

Annotated image

Annotated ultrasound images showing the Rrokitansky nodule, echogenic mesh (hair), dense shadowing foci (tip of the iceberg) and focus of possible tooth/ossification which are the characteristic features of an ovarian dermoid cyst.

Case Discussion

A mature cystic teratoma of the ovary is also called a dermoid cyst. This patient presented with a palpable lump per abdomen. The initial ultrasound scan showed the characteristic sonographic features of an ovarian dermoid cyst. CT abdomen was done later which confirmed the findings. This case highlights some of the classic features of an ovarian dermoid cyst viz. Rokitansky nodule, tip of iceberg sign, linear mesh of hair, fat-fluid levels and tooth/ossification within. Usually, ovarian dermoid cysts tend to be not more than 10 cm in size, but in this patient, the cyst was very large, reaching superiorly up to the level of the umbilicus.

Hence, based on the characteristic sonographic features, one can reliably make a diagnosis of ovarian dermoid cyst on ultrasound. When findings are not typical, a CT scan can confirm the diagnosis.

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Case information

rID: 52065
Published: 24th Mar 2017
Last edited: 17th May 2020
Inclusion in quiz mode: Included

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