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Multiple globules in a cystic ovarian teratoma
1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan. cpc_mmh@yahoo.com
Objective:
To describe the characteristic imaging findings of multiple globules and globules-fluid level in a cystic ovarian teratoma.
Design:
Descriptive case study.
Setting:
Mackay Memorial Hospital and National Yang-Ming University, Taipei, Taiwan, Republic of China.
Patient(S):
A 20-year-old woman with left abdominal discomfort and a palpable mass on the left side of the distended abdomen.
Intervention(S):
Surgical removal of a 10-cm cystic ovarian teratoma that contained chocolate-like fluid and multiple spheroid mobile globules consisting of yellowish sebaceous debris and fine hair shafts.
Main Outcome Measure(S):
Plain abdominal radiography, ultrasonography, and computed tomography (CT).
Result(S):
Plain abdominal radiography revealed no calcification in the mass. The first sonographic examination showed no movement by positional change of multiple rounded echogenic masses ranging from 0.5 cm to 2 cm in diameter, but the second CT examination done after the patient had spent some time lying down showed that the rounded masses arrayed in the upper portion of the cyst and displayed the characteristic level of globules-fluid. Thus, the differential diagnosis was multiple mobile globules in a cystic ovarian tumor.
Conclusion(S):
This case indicates that fatty masses need time to float upward in the fluid matrix of a cystic ovarian teratoma. This delayed effect should be considered when an ovarian cyst with multiple rounded echogenic masses is diagnosed by ultrasonography, CT, or magnetic resonance imaging.