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Imaging features of unusual lesions and complications associated with ovarian mature cystic teratoma

      Highlights

      • Mature cystic teratoma (MCT) is the most common germ cell tumor of the ovary. Fat density and calcification inside a cyst are hallmark.
      • Struma ovarii is the most common type of monodermal teratoma.
      • Differentiating between primary ovarian carcinoid and metastatic carcinoid is a challenge; however, bilaterality, peritoneal spreading, absence of teratomatous component, and lymphovascular invasion are suggestive of metastatic carcinoid.
      • Ovarian collision tumor are rare, but the most common type is made up of mature cystic teratoma and mucinous ovarian neoplasm. The smaller component is usually situated within the larger component (tumor within tumor) or located at the wall (kissing tumor).
      • Rupture occurs in 1-4% of ovarian teratoma. Wall discontinuity, ascites and distorted shape are key imaging features.

      Abstract

      Mature cystic teratoma (MCT) is a common neoplasm of the ovary that typically contains mature tissues of ectodermal, mesodermal, and endodermal origin. This tumor tends to affect younger women, its presentation ranges from pure cystic mass to complex solid cystic mass, and the detection of intratumoral fat component is the key diagnostic imaging feature. MCT can be associated with various complications and it demonstrates a wide spectrum of imaging findings. Associated complications include rupture, torsion, malignant transformation, and gliomatosis peritonei. MCT may also have unusual imaging features that can lead to misdiagnosis. These features may expand the differential diagnosis to include immature teratoma, monodermal teratoma, mature cystic teratoma with minimal or no fat, and collision tumor. The aim of this article was to highlight and describe the imaging features of unusual ovarian MCT lesions, and the complications associated with ovarian MCT.

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