Ovarian teratoma

Case contributed by Dr Mostafa El-Feky

Diagnosis almost certain

Presentation

Pelvic pain.

Patient Data

Age: 30 years

Gender: Female

From the case: Ovarian teratoma

MRI

Pelvic MRI

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Axial T1

Right adnexal multiseptated cystic lesion averaging around 5.5 x 7 x 7.5 cm in maximum AP, CC and side to side dimensions. It shows mixed signal intensity of both fat and high proteinaceous material. Its wall and internal septae are mostly < 3 mm with few borderline septae of 3 and 3.5 mm.

Otherwise, normal MRI features of the left ovary, no left adnexal lesions identified. Normal size, shape and signal of the uterine body and cervix with normal zonal anatomy. Minimal Douglas pouch collection. Normal features of the rectosigmoid colon and urinary bladder. No lymphadenopathies at the pelvis, iliac and para-aortic chains. Normal marrow signal pattern of the examined pelvic girdle apart from dislocated last coccygeal joint.

Case Discussion

The right adnexal cystic lesion showed T1 and T2 hyperintense nulling on fat suppression sequence consistent with fat content and T1 hyper and T2 hypointense persistent on fat suppression suggestive of high proteinaceous material, features are collectively of right adnexal teratoma.