Dermoid cyst CT: Difference between revisions
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==Overview== | ==Overview== | ||
CT scan may be helpful in the diagnosis of dermoid cyst. Findings on CT scan suggestive of ovarian dermoid cyst include low attenuating areas of fat and fat-fluid levels, rokitansky protuberance, soft [[tissue]] plugs, and cauliflower appearance with irregular borders.<ref name="pmid3293377">{{cite journal| author=Sheth S, Fishman EK, Buck JL, Hamper UM, Sanders RC| title=The variable sonographic appearances of ovarian teratomas: correlation with CT. | journal=AJR Am J Roentgenol | year= 1988 | volume= 151 | issue= 2 | pages= 331-4 | pmid=3293377 | doi=10.2214/ajr.151.2.331 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3293377 }} </ref><ref name="pmid8362057">{{cite journal| author=Occhipinti KA, Frankel SD, Hricak H| title=The ovary. Computed tomography and magnetic resonance imaging. | journal=Radiol Clin North Am | year= 1993 | volume= 31 | issue= 5 | pages= 1115-32 | pmid=8362057 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8362057 }} </ref> Findings on CT scan suggestive of spinal dermoid cysts include well defined mass isodense to [[cerebrospinal fluid]], often with hypodense components (fat) and [[calcification]], widening of the spinal canal, flattening of the [[pedicle]]s and [[laminae]], and osseous erosions.<ref name=wb>Spinal dermoid cyst. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 18, 2016.</ref> Findings on CT scan suggestive of intracranial dermoid cyst include well defined low attenuating (fat density) lobulated mass with [[calcification]]s in the wall.<ref name=wx>Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.</ref> | |||
==CT== | ==CT== | ||
===Ovarian Dermoid Cyst=== | ===Ovarian Dermoid Cyst=== | ||
*Although dermoid cysts (composed only of epidermal elements) and | *Although dermoid cysts (composed only of epidermal elements) and [[teratoma]]s (composed of mesodermal and endodermal elements) in the ovary have histological differences, the imaging findings are very similar.<ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | ||
*CT scan may be helpful in the diagnosis of ovarian dermoid cyst. Findings on CT scan suggestive of ovarian dermoid cyst include:<ref name="pmid3293377">{{cite journal| author=Sheth S, Fishman EK, Buck JL, Hamper UM, Sanders RC| title=The variable sonographic appearances of ovarian teratomas: correlation with CT. | journal=AJR Am J Roentgenol | year= 1988 | volume= 151 | issue= 2 | pages= 331-4 | pmid=3293377 | doi=10.2214/ajr.151.2.331 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3293377 }} </ref><ref name="pmid8362057">{{cite journal| author=Occhipinti KA, Frankel SD, Hricak H| title=The ovary. Computed tomography and magnetic resonance imaging. | journal=Radiol Clin North Am | year= 1993 | volume= 31 | issue= 5 | pages= 1115-32 | pmid=8362057 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8362057 }} </ref> | *CT scan may be helpful in the diagnosis of ovarian dermoid cyst. Findings on CT scan suggestive of ovarian dermoid cyst include:<ref name="pmid3293377">{{cite journal| author=Sheth S, Fishman EK, Buck JL, Hamper UM, Sanders RC| title=The variable sonographic appearances of ovarian teratomas: correlation with CT. | journal=AJR Am J Roentgenol | year= 1988 | volume= 151 | issue= 2 | pages= 331-4 | pmid=3293377 | doi=10.2214/ajr.151.2.331 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3293377 }} </ref><ref name="pmid8362057">{{cite journal| author=Occhipinti KA, Frankel SD, Hricak H| title=The ovary. Computed tomography and magnetic resonance imaging. | journal=Radiol Clin North Am | year= 1993 | volume= 31 | issue= 5 | pages= 1115-32 | pmid=8362057 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8362057 }} </ref> | ||
**Low attenuating areas of fat and fat-fluid levels | **Low attenuating areas of fat and fat-fluid levels | ||
**Rokitansky protuberance (or a dermoid plug which is a protuberance arising from the tumor wall and contains hair follicles and often fragments of bone or teeth) | **Rokitansky protuberance (or a dermoid plug which is a protuberance arising from the [[tumor]] wall and contains hair follicles and often fragments of bone or teeth) | ||
*Malignant transformation should be suspected when the cyst develops any of the following features:<ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | *[[Malignant]] transformation should be suspected when the cyst develops any of the following features:<ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | ||
**Size greater than 10 cm | **Size greater than 10 cm | ||
**Soft tissue plugs | **Soft tissue plugs | ||
**Cauliflower appearance with irregular borders | **Cauliflower appearance with irregular borders | ||
*Findings on CT scan suggestive of a ruptured ovarian dermoid cyst include:<ref name="pmid10628494">{{cite journal| author=Fibus TF| title=Intraperitoneal rupture of a benign cystic ovarian teratoma: findings at CT and MR imaging. | journal=AJR Am J Roentgenol | year= 2000 | volume= 174 | issue= 1 | pages= 261-2 | pmid=10628494 | doi=10.2214/ajr.174.1.1740261 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10628494 }} </ref><ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | *Findings on CT scan suggestive of a ruptured ovarian dermoid cyst include:<ref name="pmid10628494">{{cite journal| author=Fibus TF| title=Intraperitoneal rupture of a benign cystic ovarian teratoma: findings at CT and MR imaging. | journal=AJR Am J Roentgenol | year= 2000 | volume= 174 | issue= 1 | pages= 261-2 | pmid=10628494 | doi=10.2214/ajr.174.1.1740261 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10628494 }} </ref><ref name=rb>Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016</ref> | ||
**Hypoattenuating fatty fluid below the right | **Hypoattenuating fatty fluid below the right hemi[[diaphragm]] which is a pathognomonic finding | ||
===Spinal Dermoid Cyst=== | ===Spinal Dermoid Cyst=== | ||
*CT scan is helpful in the diagnosis of spinal dermoid cyst. Findings on CT scan suggestive of spinal dermoid cyst includes:<ref name=wb>Spinal dermoid cyst. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 18, 2016.</ref> | *CT scan is helpful in the diagnosis of spinal dermoid cyst. Findings on CT scan suggestive of spinal dermoid cyst includes:<ref name=wb>Spinal dermoid cyst. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 18, 2016.</ref> | ||
**Well defined mass | **Well defined mass | ||
**Isodense to | **Isodense to cerebrospinal fluid, often with hypodense components (fat) | ||
**Calcification may be present | **[[Calcification]] may be present | ||
**Minimal enhancement may be demonstrated | **Minimal enhancement may be demonstrated | ||
**Widening of the spinal canal | **Widening of the spinal canal | ||
**Flattening of the | **Flattening of the [[pedicle]]s and [[laminae]] | ||
**Osseous erosions may be demonstrated | **Osseous erosions may be demonstrated | ||
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*CT scan may be helpful in the diagnosis of intracranial dermoid cyst. Findings on CT scan suggestive of intracranial dermoid cyst include:<ref name=wx>Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.</ref> | *CT scan may be helpful in the diagnosis of intracranial dermoid cyst. Findings on CT scan suggestive of intracranial dermoid cyst include:<ref name=wx>Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.</ref> | ||
**Well defined low attenuating (fat density) lobulated mass | **Well defined low attenuating (fat density) lobulated mass | ||
** | **[[Calcification]]s may be present in the wall | ||
**Enhancement is uncommon. However, a thin peripheral rim enhancement may be present | **Enhancement is uncommon. However, a thin peripheral rim enhancement may be present | ||
**Rarely the dermoid cysts in the posterior fossa may appear hyperdense from a combination of saponification, microcalcification, and blood products | **Rarely the dermoid cysts in the posterior fossa may appear hyperdense from a combination of [[saponification]], microcalcification, and blood products | ||
==References== | ==References== | ||
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Latest revision as of 15:56, 30 May 2019
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Dermoid cyst CT On the Web |
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American Roentgen Ray Society Images of Dermoid cyst CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]
Overview
CT scan may be helpful in the diagnosis of dermoid cyst. Findings on CT scan suggestive of ovarian dermoid cyst include low attenuating areas of fat and fat-fluid levels, rokitansky protuberance, soft tissue plugs, and cauliflower appearance with irregular borders.[1][2] Findings on CT scan suggestive of spinal dermoid cysts include well defined mass isodense to cerebrospinal fluid, often with hypodense components (fat) and calcification, widening of the spinal canal, flattening of the pedicles and laminae, and osseous erosions.[3] Findings on CT scan suggestive of intracranial dermoid cyst include well defined low attenuating (fat density) lobulated mass with calcifications in the wall.[4]
CT
Ovarian Dermoid Cyst
- Although dermoid cysts (composed only of epidermal elements) and teratomas (composed of mesodermal and endodermal elements) in the ovary have histological differences, the imaging findings are very similar.[5]
- CT scan may be helpful in the diagnosis of ovarian dermoid cyst. Findings on CT scan suggestive of ovarian dermoid cyst include:[1][2]
- Low attenuating areas of fat and fat-fluid levels
- Rokitansky protuberance (or a dermoid plug which is a protuberance arising from the tumor wall and contains hair follicles and often fragments of bone or teeth)
- Malignant transformation should be suspected when the cyst develops any of the following features:[5]
- Size greater than 10 cm
- Soft tissue plugs
- Cauliflower appearance with irregular borders
- Findings on CT scan suggestive of a ruptured ovarian dermoid cyst include:[6][5]
- Hypoattenuating fatty fluid below the right hemidiaphragm which is a pathognomonic finding
Spinal Dermoid Cyst
- CT scan is helpful in the diagnosis of spinal dermoid cyst. Findings on CT scan suggestive of spinal dermoid cyst includes:[3]
- Well defined mass
- Isodense to cerebrospinal fluid, often with hypodense components (fat)
- Calcification may be present
- Minimal enhancement may be demonstrated
- Widening of the spinal canal
- Flattening of the pedicles and laminae
- Osseous erosions may be demonstrated
Intracranial Dermoid Cyst
- CT scan may be helpful in the diagnosis of intracranial dermoid cyst. Findings on CT scan suggestive of intracranial dermoid cyst include:[4]
- Well defined low attenuating (fat density) lobulated mass
- Calcifications may be present in the wall
- Enhancement is uncommon. However, a thin peripheral rim enhancement may be present
- Rarely the dermoid cysts in the posterior fossa may appear hyperdense from a combination of saponification, microcalcification, and blood products
References
- ↑ 1.0 1.1 Sheth S, Fishman EK, Buck JL, Hamper UM, Sanders RC (1988). "The variable sonographic appearances of ovarian teratomas: correlation with CT". AJR Am J Roentgenol. 151 (2): 331–4. doi:10.2214/ajr.151.2.331. PMID 3293377.
- ↑ 2.0 2.1 Occhipinti KA, Frankel SD, Hricak H (1993). "The ovary. Computed tomography and magnetic resonance imaging". Radiol Clin North Am. 31 (5): 1115–32. PMID 8362057.
- ↑ 3.0 3.1 Spinal dermoid cyst. http://radiopaedia.org/articles/spinal-dermoid-cyst. Accessed on February 18, 2016.
- ↑ 4.0 4.1 Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.
- ↑ 5.0 5.1 5.2 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016
- ↑ Fibus TF (2000). "Intraperitoneal rupture of a benign cystic ovarian teratoma: findings at CT and MR imaging". AJR Am J Roentgenol. 174 (1): 261–2. doi:10.2214/ajr.174.1.1740261. PMID 10628494.