Dermoid cyst ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [3]

Overview

Ultrasound may be helpful in the diagnosis of ovarian dermoid cyst. Findings on pelvic ultrasound suggestive of ovarian dermoid include unilocular, cystic adnexal mass with mural components, diffusely or partially echogenic mass with posterior sound attenuation (from the sebaceous material and hair within the cyst cavity), an echogenic interface at the edge of mass that obscures deep structures, mural hyperechoic dermoid plug, presence of fluid-fluid levels, and multiple thin, echogenic bands caused by hair in the cyst cavity (the dot-dash pattern).

Ultrasound

• Ultrasound may be helpful in the diagnosis of ovarian dermoid cyst.
• Pelvic ultrasound findings in ovarian dermoid cysts may have variable presentions. The most common presentations include:
  • Unilocular, cystic adnexal mass with mural components
  • Cystic lesion with a densely echogenic tubercle (rokitansky nodule) projecting into the cyst lumen
  • Diffusely or partially echogenic mass with the echogenic area demonstrating sound attenuation owing to sebaceous material and hair within the cyst cavity
  • Multiple thin, echogenic bands caused by hair in the cyst cavity (the dot-dash pattern)
  • Mural hyperechoic dermoid plug (rokitansky nodule)
  • Echogenic, shadowing calcific or dental (tooth) components
  • Presence of fluid-fluid levels from the sebum floating above the aqueous fluid which appears more echogenic than the sebum layer

Doppler Ultrasound

• Doppler ultrasound may be helpful in the exclusion of other vascular ovarian masses.
• The findings on doppler ultrasound may include:
  • No internal vascularity
    • Internal vascularity needs further workup to exclude a malignant lesion.

Gallery

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  Tansabdominal USG: Uterus long axis - normal uterus, left adnexal ovarian dermoid cystic lesion noted.

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  Ovarian dermoid left adnexa

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  Ovarian dermoid right adnexa

References

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