Dermoid cyst ultrasound: Difference between revisions

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==Overview==
==Overview==
Ultrasound may be helpful in the diagnosis of ovarian dermoid cyst. Findings on pelvic ultrasound suggestive of ovarian dermoid include unilocular, cystic [[adnexa]]l 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).<ref name=ok>Mature (cystic) ovarian teratoma. Radiopedia. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Accessed on February 19, 2016</ref><ref name="pmid9762997">{{cite journal| author=Patel MD, Feldstein VA, Lipson SD, Chen DC, Filly RA| title=Cystic teratomas of the ovary: diagnostic value of sonography. | journal=AJR Am J Roentgenol | year= 1998 | volume= 171 | issue= 4 | pages= 1061-5 | pmid=9762997 | doi=10.2214/ajr.171.4.9762997 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9762997  }} </ref>


==Ultrasound==
==Ultrasound==
*Ultrasound may be helpful in the diagnosis of dermoid cyst.  
*Ultrasound may be helpful in the diagnosis of ovarian dermoid cyst.  
*Findings on pelvic ultrasound suggestive of ovarian dermoid include:<ref name=ok>Mature (cystic) ovarian teratoma. Radiopedia. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Accessed on February 19, 2016</ref><ref name="pmid9762997">{{cite journal| author=Patel MD, Feldstein VA, Lipson SD, Chen DC, Filly RA| title=Cystic teratomas of the ovary: diagnostic value of sonography. | journal=AJR Am J Roentgenol | year= 1998 | volume= 171 | issue= 4 | pages= 1061-5 | pmid=9762997 | doi=10.2214/ajr.171.4.9762997 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9762997  }} </ref>
*[[Pelvic]] ultrasound findings in ovarian dermoid cysts may have variable presentions. The most common presentations include:<ref name=ok>Mature (cystic) ovarian teratoma. Radiopedia. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Accessed on February 19, 2016</ref><ref name="pmid9762997">{{cite journal| author=Patel MD, Feldstein VA, Lipson SD, Chen DC, Filly RA| title=Cystic teratomas of the ovary: diagnostic value of sonography. | journal=AJR Am J Roentgenol | year= 1998 | volume= 171 | issue= 4 | pages= 1061-5 | pmid=9762997 | doi=10.2214/ajr.171.4.9762997 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9762997 }} </ref><ref name="pmid11259710">{{cite journal| author=Outwater EK, Siegelman ES, Hunt JL| title=Ovarian teratomas: tumor types and imaging characteristics. | journal=Radiographics | year= 2001 | volume= 21 | issue= 2 | pages= 475-90 | pmid=11259710 | doi=10.1148/radiographics.21.2.g01mr09475 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11259710  }} </ref><ref name="pmid3885313">{{cite journal| author=Quinn SF, Erickson S, Black WC| title=Cystic ovarian teratomas: the sonographic appearance of the dermoid plug. | journal=Radiology | year= 1985 | volume= 155 | issue= 2 | pages= 477-8 | pmid=3885313 | doi=10.1148/radiology.155.2.3885313 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3885313 }} </ref>
**Unilocular, cystic adnexal mass with some mural components
**Unilocular, cystic [[adnexa]]l mass with mural components
**Diffusely or partially echogenic mass with posterior sound attenuation from the sebaceous material and hair within the cyst cavity
**Cystic lesion with a densely [[echogenic]] tubercle (rokitansky nodule) projecting into the cyst lumen
***An echogenic interface at the edge of mass that obscures deep structures (the tip of the iceberg sign)
**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)  
**Mural hyperechoic dermoid plug (rokitansky nodule)  
**Echogenic, shadowing calcific or dental (tooth) components
**[[Echogenic]], shadowing calcific or dental (tooth) components
**Presence of fluid-fluid levels
**Presence of fluid-fluid levels from the [[sebum]] floating above the aqueous fluid which appears more echogenic than the sebum layer
**Multiple thin, echogenic bands caused by hair in the cyst cavity (the dot-dash pattern)


===Doppler Ultrasound===
===Doppler Ultrasound===
*Doppler ultrasound may be helpful in the exclusion of vascular masses and the findings may include:<ref name=ok>Mature (cystic) ovarian teratoma. Radiopedia. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Accessed on February 19, 2016</ref>
*[[Doppler]] ultrasound may be helpful in the exclusion of other [[vascular]] [[ovarian]] masses.
*The findings on doppler ultrasound may include:<ref name=ok>Mature (cystic) ovarian teratoma. Radiopedia. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Accessed on February 19, 2016</ref>
**No internal vascularity  
**No internal vascularity  
***Internal vascularity needs further workup to exclude a malignant lesion.
***Internal vascularity needs further workup to exclude a [[malignant]] lesion.


==Gallery==
==Gallery==
<gallery>
<gallery>
Image:Submental_dermoid_cyst_US1.jpg|The ultrasound of the submental area showing a sizeable infrasonic formation with distinct boundaries.<ref name="pmid21922020">{{cite journal| author=Makos C, Noussios G, Peios M, Gougousis S, Chouridis P| title=Dermoid cysts of the floor of the mouth: two case reports. | journal=Case Rep Med | year= 2011 | volume= 2011 | issue=  | pages= 362170 | pmid=21922020 | doi=10.1155/2011/362170 | pmc=PMC3172983 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922020  }} </ref>
Image:Ovarian-dermoid_1.jpg|Tansabdominal USG: Uterus long axis - normal uterus, left adnexal ovarian dermoid cystic  lesion noted.<ref name=sc>Image courtesy of Dr Maulik S Patel[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ovarian-dermoid-5 ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>


Image:Submental_dermoid_cyst_US2.gif|The ultrasound of the submental area showing a sizeable infrasonic formation with distinct boundaries.<ref name="pmid21922020">{{cite journal| author=Makos C, Noussios G, Peios M, Gougousis S, Chouridis P| title=Dermoid cysts of the floor of the mouth: two case reports. | journal=Case Rep Med | year= 2011 | volume= 2011 | issue=  | pages= 362170 | pmid=21922020 | doi=10.1155/2011/362170 | pmc=PMC3172983 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922020  }} </ref>
Image:Ovarian-dermoid-3.jpg|Ovarian dermoid left adnexa<ref name=sc>Image courtesy of Dr Maulik S Patel[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ovarian-dermoid-5 ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>


Image:Ovarian-dermoid_1.jpg|Tansabdominal USG: Uterus long axis - normal uterus. Left adnexal ovarian dermoid cystic  lesion noted.<ref>Image courtesy of Dr Maulik S Patel[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ovarian-dermoid-5 ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
Image:Ovarian-dermoid-4.jpg|Ovarian dermoid right adnexa<ref name=sc>Image courtesy of Dr Maulik S Patel[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ovarian-dermoid-5 ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>


Image:Ovarian-dermoid-2.jpg|Ovarian dermoid left adnexal cystic lesion<ref>Image courtesy of Dr Maulik S Patel[http://www.radiopaedia.org Radiopaedia] (original file[http://radiopaedia.org/cases/ovarian-dermoid-5 ''here'']). [http://radiopaedia.org/licence] CreativeCommons BY-SANC</ref>
</gallery>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 15:59, 30 May 2019

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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).[1][2]

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:[1][2][3][4]
    • 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:[1]
    • No internal vascularity
      • Internal vascularity needs further workup to exclude a malignant lesion.

Gallery

  • Tansabdominal USG: Uterus long axis - normal uterus, left adnexal ovarian dermoid cystic lesion noted.[5]

    Tansabdominal USG: Uterus long axis - normal uterus, left adnexal ovarian dermoid cystic lesion noted.[5]

  • Ovarian dermoid left adnexa[5]

    Ovarian dermoid left adnexa[5]

  • Ovarian dermoid right adnexa[5]

    Ovarian dermoid right adnexa[5]

References

  1. ↑ 1.0 1.1 1.2 Mature (cystic) ovarian teratoma. Radiopedia. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Accessed on February 19, 2016
  2. ↑ 2.0 2.1 Patel MD, Feldstein VA, Lipson SD, Chen DC, Filly RA (1998). "Cystic teratomas of the ovary: diagnostic value of sonography". AJR Am J Roentgenol. 171 (4): 1061–5. doi:10.2214/ajr.171.4.9762997. PMID 9762997.
  3. ↑ Outwater EK, Siegelman ES, Hunt JL (2001). "Ovarian teratomas: tumor types and imaging characteristics". Radiographics. 21 (2): 475–90. doi:10.1148/radiographics.21.2.g01mr09475. PMID 11259710.
  4. ↑ Quinn SF, Erickson S, Black WC (1985). "Cystic ovarian teratomas: the sonographic appearance of the dermoid plug". Radiology. 155 (2): 477–8. doi:10.1148/radiology.155.2.3885313. PMID 3885313.
  5. ↑ 5.0 5.1 5.2 Image courtesy of Dr Maulik S PatelRadiopaedia (original filehere). [1] CreativeCommons BY-SANC


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