Pelvic (ovarian) dermoid cyst
Married patient came to our center, complaining of acute pelvic pain with history of previous CS 2 months ago. US revealed a large pelvic hyperechoiec lesion with distal acoustic shadowing and suspected missed towel.
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Well circumscribed deep pelvic cystic adnexal mass lesion, located just ventral to the uterine body merging with the right broad ligament. The lesion shows thick wall, internal mixed inhomogeneous fatty attenuation elements, soft tissue densities, Rokitansky protuberance and dense tooth like structure. It is seen abutting the external iliac vessels and causing mild contour bulge of the anterior abdominal wall.
This is a classic case of dermoid cyst (teratodermoid, mature teratoma), by US (unavialable images) we suspect a missed surgical towel regarding the patient history however we did not exclude ovarian teratoma.
We recommended complementary CT scanning.
Dermoid cyst is a term used almost always interchangeably with teratomas.
Dermoids are tumors derived from more than one germ layers, usually the three (ectoderm, mesoderm and endoderm).