This patient went on to have surgical resection of the larger lesions which was confirmed to have ruptured. 

Histology

MACROSCOPIC DESCRIPTION: A solid nodule 40mm in diameter with a fatty cut surface and hair tufts attached to its outer surface.  Sectioning reveals bony tissue embedded within the fat (?tooth).  

MICROSCOPIC DESCRIPTION: Sections show a mature cystic teratoma which predominantly consists of adnexal structures and skin.  However there is a small amount of mature glial tissue present.  No immature elements are seen.

FINAL DIAGNOSIS: Mature cystic teratoma with majority of elements in keeping with a dermoid cyst.  Focal mature glial tissue.  No immature elements.

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