Dermoid cyst differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Dermoid cyst}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Dermoid_cyst]]
{{CMG}}{{AE}} {{STM}}
{{CMG}}{{AE}} {{STM}}


==Overview==
==Overview==
Dermoid cyst must be differentiated from [[teratoma]], as well as other common [[benign tumor]]s that develop in the head and neck, [[ovaries]], or spine (such as [[pilar cyst]]s, steatocystoma, pilomatrixoma, [[encephalocele]], [[vascular malformation]]s, lipoleiomyoma, [[pilonidal cyst]], and [[lipoma]]).  
Dermoid cyst must be differentiated from [[teratoma]], as well as other common [[benign tumor]]s that develop in the head and neck, [[ovaries]], or spine (such as [[pilar cyst]]s, steatocystoma, pilomatrixoma, [[encephalocele]], [[vascular malformation]]s, lipoleiomyoma, [[pilonidal cyst]], and [[lipoma]]).<ref name="pmid23056976">{{cite journal| author=Ohta N, Watanabe T, Ito T, Kubota T, Suzuki Y, Ishida A et al.| title=A case of sublingual dermoid cyst: extending the limits of the oral approach. | journal=Case Rep Otolaryngol | year= 2012 | volume= 2012 | issue=  | pages= 634949 | pmid=23056976 | doi=10.1155/2012/634949 | pmc=PMC3465894 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23056976  }} </ref><ref name="wd">Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 4, 2016.</ref><ref name="pmid23508636">{{cite journal| author=Sharma M, Mally R, Velho V| title=Ruptured conus medullaris dermoid cyst with fat droplets in the central canal [corrected]. | journal=Asian Spine J | year= 2013 | volume= 7 | issue= 1 | pages= 50-4 | pmid=23508636 | doi=10.4184/asj.2013.7.1.50 | pmc=PMC3596585 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23508636  }} </ref><ref name="pmid23508636">{{cite journal| author=Sharma M, Mally R, Velho V| title=Ruptured conus medullaris dermoid cyst with fat droplets in the central canal [corrected]. | journal=Asian Spine J | year= 2013 | volume= 7 | issue= 1 | pages= 50-4 | pmid=23508636 | doi=10.4184/asj.2013.7.1.50 | pmc=PMC3596585 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23508636  }} </ref><ref>Intracranial dermoid cyst. Radiopaedia.org. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1 Accessed on February 5, 2016.</ref>


==Differential Diagnosis==
==Differential Diagnosis==
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*Steatocystoma multiplex
*Steatocystoma multiplex
*Pilomatrixoma
*Pilomatrixoma
*[[Encephalocele]] (when dermoid cysts appear on the medial aspect of the orbit)
*[[Encephalocele]] (when dermoid cysts appear on the medial aspect of the [[orbit]])
*[[Ranula]]
*[[Ranula]]
*Vascular [[leiomyoma]] of the extracranial [[scalp]]
*Vascular [[leiomyoma]] of the extracranial [[scalp]]
Line 21: Line 21:
===Ovarian Dermoid Cysts===
===Ovarian Dermoid Cysts===
*Ovarian dermoid cysts must be differentiated from the following:
*Ovarian dermoid cysts must be differentiated from the following:
**[[Haemorrhagic ovarian cyst]]
**Haemorrhagic [[ovarian cyst]]
**Pedunculated [[lipoleiomyoma]] of the [[uterus]]
**Pedunculated lipo[[leiomyoma]] of the [[uterus]]
**Ovarian serous or mucinous [[cystadenoma]]/[[cystadenocarcinoma]]  
**Ovarian serous or mucinous [[cystadenoma]]/[[cystadenocarcinoma]]
 
 
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! colspan="2" rowspan="4" |Diseases
| colspan="6" |'''Clinical manifestations'''
! colspan="4" rowspan="2" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
| rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Age of onset'''
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
! colspan="2" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunohistopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Pelvic/abdominal pain or pressure
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Vaginal bleeding/discharge
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |GI dysturbance
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Fever'''
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Tenderness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT scan/US
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI
|-
! colspan="14" style="background: #7d7d7d; color: #FFFFFF; text-align: center;" |Gynecologic
|-
| rowspan="15" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovary|Ovarian]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovarian cyst|Dermoid cyst]]<br><ref name="pmid20505067">{{cite journal |vauthors=Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, Coleman B, Depriest P, Doubilet PM, Goldstein SR, Hamper UM, Hecht JL, Horrow M, Hur HC, Marnach M, Patel MD, Platt LD, Puscheck E, Smith-Bindman R |title=Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement |journal=Radiology |volume=256 |issue=3 |pages=943–54 |date=September 2010 |pmid=20505067 |doi=10.1148/radiol.10100213 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[Reproductive system|reproductive]] age (20 -30 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* High level of [[estrogen]] +/–
| style="background: #F5F5F5; padding: 5px;" |
* [[cyst]] with no internal echo and with posterior acoustic enhancement
| style="background: #F5F5F5; padding: 5px;" |
* simple [[cyst]] with no internal echo or [[septa]]
| style="background: #F5F5F5; padding: 5px;" |
* NA
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[imaging]]
| style="background: #F5F5F5; padding: 5px;" |
* It is associated with [[hyperestrogenism]] and [[endometrial hyperplasia]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovarian cyst|Follicular cysts]]<br><ref name="pmid20505067">{{cite journal |vauthors=Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, Coleman B, Depriest P, Doubilet PM, Goldstein SR, Hamper UM, Hecht JL, Horrow M, Hur HC, Marnach M, Patel MD, Platt LD, Puscheck E, Smith-Bindman R |title=Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement |journal=Radiology |volume=256 |issue=3 |pages=943–54 |date=September 2010 |pmid=20505067 |doi=10.1148/radiol.10100213 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[Reproductive system|reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* High level of [[estrogen]] +/–
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see a >3 cm simple [[cyst]] with no internal echo and with posterior acoustic enhancement
| style="background: #F5F5F5; padding: 5px;" |
* simple [[cyst]] with no internal echo or [[septa]]
| style="background: #F5F5F5; padding: 5px;" |
* NA
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[imaging]]
| style="background: #F5F5F5; padding: 5px;" |
* It is associated with [[hyperestrogenism]] and [[endometrial hyperplasia]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ovarian cyst|Theca lutein cysts]]<br><ref name="pmid2455880">{{cite journal |vauthors=Montz FJ, Schlaerth JB, Morrow CP |title=The natural history of theca lutein cysts |journal=Obstet Gynecol |volume=72 |issue=2 |pages=247–51 |date=August 1988 |pmid=2455880 |doi= |url=}}</ref><ref name="Southam1962">{{cite journal|last1=Southam|first1=Anna L.|title=Massive Ovarian Hyperstimulation with Clomiphene Citrate|journal=JAMA: The Journal of the American Medical Association|volume=181|issue=5|year=1962|pages=443|issn=0098-7484|doi=10.1001/jama.1962.03050310083018b}}</ref><ref name="NguyenReid1986">{{cite journal|last1=Nguyen|first1=K T|last2=Reid|first2=R L|last3=Sauerbrei|first3=E|title=Antenatal sonographic detection of a fetal theca lutein cyst: a clue to maternal diabetes mellitus.|journal=Journal of Ultrasound in Medicine|volume=5|issue=11|year=1986|pages=665–667|issn=02784297|doi=10.7863/jum.1986.5.11.665}}</ref>
 
| style="background: #F5F5F5; padding: 5px;" |
*[[Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* Depends on the underlying [[etiology]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see bilaterally enlarged [[ovaries]] with multiple [[cysts]]
| style="background: #F5F5F5; padding: 5px;" |
* Multiple bilateral [[cysts]]
| style="background: #F5F5F5; padding: 5px;" |
* Theca interna cell [[Hyperplasia]]
| style="background: #F5F5F5; padding: 5px;" |
*[[History and Physical examination|History]]/<br>[[imaging]]
| style="background: #F5F5F5; padding: 5px;" |
* It is associated with [[Hydatidiform mole|hydatidiform moles]], [[choriocarcinoma]], [[diabetes mellitus]] and [[clomiphene]] intake ([[ovulation]] induction)
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Serous cystadenoma/carcinoma<br><ref name="JungLee20022">{{cite journal|last1=Jung|first1=Seung Eun|last2=Lee|first2=Jae Mun|last3=Rha|first3=Sung Eun|last4=Byun|first4=Jae Young|last5=Jung|first5=Jung Im|last6=Hahn|first6=Seong Tai|title=CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis|journal=RadioGraphics|volume=22|issue=6|year=2002|pages=1305–1325|issn=0271-5333|doi=10.1148/rg.226025033}}</ref><ref name="ImaiKiyozuka1990">{{cite journal|last1=Imai|first1=Shunsuke|last2=Kiyozuka|first2=Yasuhiko|last3=Maeda|first3=Hiroko|last4=Noda|first4=Tuneo|last5=Hosick|first5=Howard L.|title=Establishment and Characterization of a Human Ovarian Serous Cystadenocarcinoma Cell Line That Produces the Tumor Markers CA-125 and Tissue Polypeptide Antigen|journal=Oncology|volume=47|issue=2|year=1990|pages=177–184|issn=0030-2414|doi=10.1159/000226813}}</ref><ref name="pmid15087669">{{cite journal |vauthors=Malpica A, Deavers MT, Lu K, Bodurka DC, Atkinson EN, Gershenson DM, Silva EG |title=Grading ovarian serous carcinoma using a two-tier system |journal=Am. J. Surg. Pathol. |volume=28 |issue=4 |pages=496–504 |date=April 2004 |pmid=15087669 |doi= |url=}}</ref><ref name="pmid22405464">{{cite journal |vauthors=Li J, Fadare O, Xiang L, Kong B, Zheng W |title=Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis |journal=J Hematol Oncol |volume=5 |issue= |pages=8 |date=March 2012 |pmid=22405464 |doi=10.1186/1756-8722-5-8 |url=}}</ref>
 
| style="background: #F5F5F5; padding: 5px;" |
* >55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* Elevated levels of [[CA-125|serum cancer antigen-125]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see simple or multiloculated [[cyst]]
* In serous cystadenocarcinoma we may see [[papillary]] projection inside the cyst
* In serous cystadenocarcinoma we may see [[ascites]]
| style="background: #F5F5F5; padding: 5px;" |
* We may see a simple [[cyst]] with beak sign, hypointense on T1 and hyperintense on T2
* We may see some Solid [[malignant]] components inside the [[cyst]] with intermediate signal on T1 and T2
| style="background: #F5F5F5; padding: 5px;" |
*[[Cyst]] wall consist of [[benign]]/[[malignant]] [[Fallopian tube|Fallopian]] [[Epithelium|epithelial]] layer
 
*[[Psammoma body]]
* We may see [[papillary]] projection inside the [[cyst]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Most common [[ovarian neoplasm]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mucinous cystadenoma]]/carcinoma<br><ref name="pmid9850171">{{cite journal |vauthors=Hoerl HD, Hart WR |title=Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=22 |issue=12 |pages=1449–62 |date=December 1998 |pmid=9850171 |doi= |url=}}</ref><ref name="pmid11075847">{{cite journal |vauthors=Lee KR, Scully RE |title=Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with 'pseudomyxoma peritonei' |journal=Am. J. Surg. Pathol. |volume=24 |issue=11 |pages=1447–64 |date=November 2000 |pmid=11075847 |doi= |url=}}</ref><ref name="JungLee2002">{{cite journal|last1=Jung|first1=Seung Eun|last2=Lee|first2=Jae Mun|last3=Rha|first3=Sung Eun|last4=Byun|first4=Jae Young|last5=Jung|first5=Jung Im|last6=Hahn|first6=Seong Tai|title=CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis|journal=RadioGraphics|volume=22|issue=6|year=2002|pages=1305–1325|issn=0271-5333|doi=10.1148/rg.226025033}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* >55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* Elevated levels of [[CA-125|serum cancer antigen-125]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see large simple [[cyst]] with [[septation]]
* In [[mucinous cystadenocarcinoma]] we may see thickened internal [[septation]] with solid components inside the [[Cyst of urachus|cyst]]
| style="background: #F5F5F5; padding: 5px;" |
* Stained glass appearance due to variable signal intensity on T1 and T2
* The more [[mucin]] we have, there is more intensity on T1
* and less intensity on T2
| style="background: #F5F5F5; padding: 5px;" |
*[[Cyst]] wall consist of [[Columnar epithelia|columnar]] [[Endocervix|endocervical]] [[epithelium]]
* We may see gelatinous [[mucin]] inside the [[cyst]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* It may cause [[pseudomyxoma peritonei]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometrioma]]<br><ref name="pmid9848302">{{cite journal |vauthors=Mol BW, Bayram N, Lijmer JG, Wiegerinck MA, Bongers MY, van der Veen F, Bossuyt PM |title=The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis |journal=Fertil. Steril. |volume=70 |issue=6 |pages=1101–8 |date=December 1998 |pmid=9848302 |doi= |url=}}</ref><ref name="KinkelFrei2005">{{cite journal|last1=Kinkel|first1=Karen|last2=Frei|first2=Kathrin A.|last3=Balleyguier|first3=Corinne|last4=Chapron|first4=Charles|title=Diagnosis of endometriosis with imaging: a review|journal=European Radiology|volume=16|issue=2|year=2005|pages=285–298|issn=0938-7994|doi=10.1007/s00330-005-2882-y}}</ref><ref name="de ZieglerBorghese2010">{{cite journal|last1=de Ziegler|first1=Dominique|last2=Borghese|first2=Bruno|last3=Chapron|first3=Charles|title=Endometriosis and infertility: pathophysiology and management|journal=The Lancet|volume=376|issue=9742|year=2010|pages=730–738|issn=01406736|doi=10.1016/S0140-6736(10)60490-4}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
*[[Women's College Hospital|Women]] in [[reproductive]] age (15 -45 y/o)
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px;" |
*[[Iron deficiency anemia]]
 
* Elevated levels of [[CA-125|serum cancer antigen-125]]
* Increased levels of [[interleukin 1]], [[chemoattractant]] protein-1, and [[Interferon-gamma|interferon gamma]]
| style="background: #F5F5F5; padding: 5px;" |
* Complex [[mass]] on [[Ultrasound|US]]
* Increased [[Doppler ultrasound|Doppler]] flow because of increased vascularture
* It may present with [[catamenial pneumothorax]], [[hemothorax]], and [[lung]] [[nodules]] in [[CT scan]].
| style="background: #F5F5F5; padding: 5px;" |
* hyperintensity on T1-weighted images and a hypointensity on T2-weighted [[images]]
* Powder burn [[hemorrhages]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Chocolate cyst]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Laparoscopy]]
| style="background: #F5F5F5; padding: 5px;" |
* It may cause [[infertility]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Teratoma]]<br><ref name="KawaiKano1992">{{cite journal|last1=Kawai|first1=Michiyasu|last2=Kano|first2=Takeo|last3=Kikkawa|first3=Fumitaka|last4=Morikawa|first4=Yoshimitsu|last5=Oguchi|first5=Hidenori|last6=Nakashima|first6=Nobuo|last7=Ishizuka|first7=Takao|last8=Kuzuya|first8=Kazuo|last9=Ohta|first9=Masahiro|last10=Arii|first10=Yoshitaro|last11=Tomoda|first11=Yutaka|title=Seven tumor markers in benign and malignant germ cell tumors of the ovary|journal=Gynecologic Oncology|volume=45|issue=3|year=1992|pages=248–253|issn=00908258|doi=10.1016/0090-8258(92)90299-X}}</ref><ref name="DunzendorferdeLAS MORENAS1999">{{cite journal|last1=Dunzendorfer|first1=Thomas|last2=deLAS MORENAS|first2=ANTONIO|last3=Kalir|first3=Tamara|last4=Levin|first4=Robert M.|title=Struma Ovarii and Hyperthyroidism|journal=Thyroid|volume=9|issue=5|year=1999|pages=499–502|issn=1050-7256|doi=10.1089/thy.1999.9.499}}</ref><ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref><ref name="SabaGuerriero2009">{{cite journal|last1=Saba|first1=Luca|last2=Guerriero|first2=Stefano|last3=Sulcis|first3=Rosa|last4=Virgilio|first4=Bruna|last5=Melis|first5=GianBenedetto|last6=Mallarini|first6=Giorgio|title=Mature and immature ovarian teratomas: CT, US and MR imaging characteristics|journal=European Journal of Radiology|volume=72|issue=3|year=2009|pages=454–463|issn=0720048X|doi=10.1016/j.ejrad.2008.07.044}}</ref>
 
| style="background: #F5F5F5; padding: 5px;" |
* 10-30 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* High level of [[HCG]] and [[LDH]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see [[cystic]] [[adnexal]] [[mass]] with mural components and echogenic [[lesion]] due to [[calcification]]
* The iceberg [[sign]]
* Dot-dash pattern
| style="background: #F5F5F5; padding: 5px;" |
* We may see evidence of [[fat]] components
| style="background: #F5F5F5; padding: 5px;" |
* All three [[Germ layer|germ layers]] [[Cell (biology)|cell]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* It may cause [[ovarian torsion]]
 
* May content [[thyroid]] [[tissue]] and cause [[hyperthyroidism]]
* In plane [[radiography]] we may see [[calcification]] due to the presence of [[tooth]] in the [[tumor]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dysgerminoma]]<br><ref name="DganiShoham(Schwartz)1988">{{cite journal|last1=Dgani|first1=R.|last2=Shoham(Schwartz)|first2=Z.|last3=Czernobilsky|first3=B.|last4=Kaftori|first4=A.|last5=Borenstein|first5=R.|last6=Lancet|first6=M.|title=Lactic dehydrogenase, alkaline phosphatase and human chorionic gonadotropin in a pure ovarian dysgerminoma|journal=Gynecologic Oncology|volume=30|issue=1|year=1988|pages=44–50|issn=00908258|doi=10.1016/0090-8258(88)90044-3}}</ref><ref name="pmid8188914">{{cite journal |vauthors=Tanaka YO, Kurosaki Y, Nishida M, Michishita N, Kuramoto K, Itai Y, Kubo T |title=Ovarian dysgerminoma: MR and CT appearance |journal=J Comput Assist Tomogr |volume=18 |issue=3 |pages=443–8 |date=1994 |pmid=8188914 |doi= |url=}}</ref>
 
| style="background: #F5F5F5; padding: 5px;" |
* in the second to third decade of life
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* High level of [[HCG]] and [[LDH]]
*[[Hypercalcemia]]
| style="background: #F5F5F5; padding: 5px;" |
* Multilobulated solid [[Mass|masses]]
| style="background: #F5F5F5; padding: 5px;" |
* We may see [[ovarian]] [[mass]] with septation which are hyperintense on T1 and hypo or isointense on T2 [[imaging]]
| style="background: #F5F5F5; padding: 5px;" |
* Sheets fried egg appearance [[Cell (biology)|cells]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Same as [[male]] [[seminoma]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Yolk sac tumor]]<br><ref name="Yang2000">{{cite journal|last1=Yang|first1=Grace C.H.|title=Fine-needle aspiration cytology of Schiller-Duval bodies of yolk-sac tumor|journal=Diagnostic Cytopathology|volume=23|issue=4|year=2000|pages=228–232|issn=8755-1039|doi=10.1002/1097-0339(200010)23:4<228::AID-DC2>3.0.CO;2-M}}</ref><ref name="LevitinHaller1996">{{cite journal|last1=Levitin|first1=A|last2=Haller|first2=K D|last3=Cohen|first3=H L|last4=Zinn|first4=D L|last5=O'Connor|first5=M T|title=Endodermal sinus tumor of the ovary: imaging evaluation.|journal=American Journal of Roentgenology|volume=167|issue=3|year=1996|pages=791–793|issn=0361-803X|doi=10.2214/ajr.167.3.8751702}}</ref><ref name="TalermanHaije1974">{{cite journal|last1=Talerman|first1=A.|last2=Haije|first2=W. G.|title=Alpha-fetoprotein and germ cell tumors: A possible role of yolk sac tumor in production of alpha-fetoprotein|journal=Cancer|volume=34|issue=5|year=1974|pages=1722–1726|issn=0008-543X|doi=10.1002/1097-0142(197411)34:5<1722::AID-CNCR2820340521>3.0.CO;2-F}}</ref>
 
| style="background: #F5F5F5; padding: 5px;" |
* Young [[children]]
*[[Male]] [[infants]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px;" |
* High levels of [[AFP]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see a combination of echogenic and hypoechoic components
| style="background: #F5F5F5; padding: 5px;" |
*[[Ovarian mass]] with [[hemorrhagic]] areas
| style="background: #F5F5F5; padding: 5px;" |
* Yellow appearance
 
*[[Hemorrhagic]]
 
* Schiller-Duval bodies ([[glomeruli]] like structures)
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* The other name is [[Ovarian cyst|ovarian]] [[endodermal sinus tumor]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fibroma]]<br><ref name="pmid13148256">{{cite journal |vauthors=MEIGS JV |title=Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome |journal=Am. J. Obstet. Gynecol. |volume=67 |issue=5 |pages=962–85 |date=May 1954 |pmid=13148256 |doi= |url=}}</ref><ref name="SivanesaratnamDutta1990">{{cite journal|last1=Sivanesaratnam|first1=V.|last2=Dutta|first2=R.|last3=Jayalakshmi|first3=P.|title=Ovarian fibroma - clinical and histopathological characteristics|journal=International Journal of Gynecology & Obstetrics|volume=33|issue=3|year=1990|pages=243–247|issn=00207292|doi=10.1016/0020-7292(90)90009-A}}</ref><ref name="AbadCazorla1999">{{cite journal|last1=Abad|first1=Antonio|last2=Cazorla|first2=Eduardo|last3=Ruiz|first3=Fernando|last4=Aznar|first4=Ismael|last5=Asins|first5=Enrique|last6=Llixiona|first6=Joaquin|title=Meigs' syndrome with elevated CA125: case report and review of the literature|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=82|issue=1|year=1999|pages=97–99|issn=03012115|doi=10.1016/S0301-2115(98)00174-2}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* >50 y/o
| style="background: #F5F5F5; padding: 5px;" |
* Pulling sensation in the [[groin]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
* High levels of [[CA-125]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[CT scan]] we may see a unilateral [[mass]] with poor contrast enhancement
| style="background: #F5F5F5; padding: 5px;" |
* Low signal intensity on T1 and T2
 
* We may see scattered hyperintense areas due to  [[edema]] or [[cystic]] [[degeneration]]
| style="background: #F5F5F5; padding: 5px;" |
* Spindle-shaped [[fibroblast]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* It may cause [[Meigs syndrome]] ([[ovarian fibroma]], [[ascites]], and [[hydrothorax]])
* It may cause [[ovarian torsion]]
* It may cause [[pleural effusion]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thecoma]]<br><ref name="YaghoobianPinck1983">{{cite journal|last1=Yaghoobian|first1=Jahanguir|last2=Pinck|first2=Robert L.|title=Ultrasound findings in thecoma of the ovary|journal=Journal of Clinical Ultrasound|volume=11|issue=2|year=1983|pages=91–93|issn=00912751|doi=10.1002/jcu.1870110207}}</ref><ref name="LiZhang2012">{{cite journal|last1=Li|first1=Xinchun|last2=Zhang|first2=Weidong|last3=Zhu|first3=Guangbin|last4=Sun|first4=Congpeng|last5=Liu|first5=Qingyu|last6=Shen|first6=Yuechun|title=Imaging Features and Pathologic Characteristics of Ovarian Thecoma|journal=Journal of Computer Assisted Tomography|volume=36|issue=1|year=2012|pages=46–53|issn=0363-8715|doi=10.1097/RCT.0b013e31823f6186}}</ref><ref name="ProctorGreeley1951">{{cite journal|last1=Proctor|first1=Francis E.|last2=Greeley|first2=Joseph P.|last3=Rathmell|first3=Thomas K.|title=Malignant thecoma of the ovary|journal=American Journal of Obstetrics and Gynecology|volume=62|issue=1|year=1951|pages=185–192|issn=00029378|doi=10.1016/0002-9378(51)91109-X}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* >50 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px;" |
*[[Postmenopausal bleeding]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
* High level of [[estrogen]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see non-specific [[ovarian]] [[mass]]
 
* We may see evidence of [[endometrial hyperplasia]] due to increased level of [[estrogen]]
| style="background: #F5F5F5; padding: 5px;" |
* Hyperintense on T2
* T1 intensity depends on the amount of [[fibrous tissue]] ([[fibrous tissue]] lead to hypointensity)
| style="background: #F5F5F5; padding: 5px;" |
* Lipid-laden [[Stromal cell|stromal cells]] with pale, vaculolated [[cytoplasm]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* We may see [[endometrial cancer]] as e result of hyper-[[Estrogen|estrogenism]]
* We may see [[ovarian]] fibrothecoma (mixture of [[fibroma]] and [[thecoma]])
 
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granulosa cell tumour|Granulosa cell tumor]]<br><ref name="pmid17945423">{{cite journal |vauthors=Pectasides D, Pectasides E, Psyrri A |title=Granulosa cell tumor of the ovary |journal=Cancer Treat. Rev. |volume=34 |issue=1 |pages=1–12 |date=February 2008 |pmid=17945423 |doi=10.1016/j.ctrv.2007.08.007 |url=}}</ref><ref name="StenwigHazekamp1979">{{cite journal|last1=Stenwig|first1=Jan Trygve|last2=Hazekamp|first2=Johan The.|last3=Beecham|first3=Jackson B.|title=Granulosa cell tumors of the ovary. A clinicopathological study of 118 cases with long-term follow-up|journal=Gynecologic Oncology|volume=7|issue=2|year=1979|pages=136–152|issn=00908258|doi=10.1016/0090-8258(79)90090-8}}</ref><ref name="pmid9386298">{{cite journal |vauthors=Morikawa K, Hatabu H, Togashi K, Kataoka ML, Mori T, Konishi J |title=Granulosa cell tumor of the ovary: MR findings |journal=J Comput Assist Tomogr |volume=21 |issue=6 |pages=1001–4 |date=1997 |pmid=9386298 |doi= |url=}}</ref><ref name="pmid10227493">{{cite journal |vauthors=Ko SF, Wan YL, Ng SH, Lee TY, Lin JW, Chen WJ, Kung FT, Tsai CC |title=Adult ovarian granulosa cell tumors: spectrum of sonographic and CT findings with pathologic correlation |journal=AJR Am J Roentgenol |volume=172 |issue=5 |pages=1227–33 |date=May 1999 |pmid=10227493 |doi=10.2214/ajr.172.5.10227493 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* 50-60 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +
| style="background: #F5F5F5; padding: 5px;" |
*[[Postmenopausal bleeding]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
* High level of [[estrogen]] and [[Progesterone|progesteron]]
* We may see [[inhibin]], [[calretinin]], and [[Ki-67]] on the surface of [[Granulosa cell|granulosa]] [[tumor]] [[Cell (biology)|cells]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see solid, [[cystic]], or multiloculated solid and [[cystic]] [[mass]]
| style="background: #F5F5F5; padding: 5px;" |
* We may see solid, [[Cystic Cytoplasm|cystic]], or multiloculated solid and [[cystic]] [[mass]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Call-Exner bodies]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[postmenopausal]] [[women]] may cause [[breast]] [[tenderness]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sertoli-Leydig cell tumor|Sertoli-leydig cell tumor]]<br><ref name="LantzschStoerer2001">{{cite journal|last1=Lantzsch|first1=T.|last2=Stoerer|first2=S.|last3=Lawrenz|first3=K.|last4=Buchmann|first4=J.|last5=Strauss|first5=H.-G.|last6=Koelbl|first6=H.|title=Sertoli-Leydig cell tumor|journal=Archives of Gynecology and Obstetrics|volume=264|issue=4|year=2001|pages=206–208|issn=0932-0067|doi=10.1007/s004040000114}}</ref><ref name="JungRha2005">{{cite journal|last1=Jung|first1=Seung Eun|last2=Rha|first2=Sung Eun|last3=Lee|first3=Jae Mun|last4=Park|first4=Soo Youn|last5=Oh|first5=Soon Nam|last6=Cho|first6=Kyoung Sik|last7=Lee|first7=Eun Ju|last8=Byun|first8=Jae Young|last9=Hahn|first9=Seong Tai|title=CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary|journal=American Journal of Roentgenology|volume=185|issue=1|year=2005|pages=207–215|issn=0361-803X|doi=10.2214/ajr.185.1.01850207}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* 15 to 35 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
* Elevated [[serum]] [[testosterone]] level
* Elevated [[alpha-fetoprotein]]
| style="background: #F5F5F5; padding: 5px;" |
* In [[Ultrasound|US]] we may see unilateral Well-defined hypoechoic [[lesion]]
 
| style="background: #F5F5F5; padding: 5px;" |
* Low T2 signal intensity
* areas of high signal intensity
| style="background: #F5F5F5; padding: 5px;" |
* Lydig [[Cell (biology)|cells]] (Polygonal pink [[Cell (biology)|cells]] with [[eosinophilic]] [[cytoplasm]]
 
*[[Sertoli cell|Sertoli cells]] (clear vacuolated [[cytoplasm]])
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* It may cause [[virilization]] [[Symptom|symptoms]] and [[amenorrhea]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brenner tumor of ovary|Brenner tumor<br>]]<ref name="ShevchukFenoglio1980">{{cite journal|last1=Shevchuk|first1=Maria M.|last2=Fenoglio|first2=Cecilia M.|last3=Richart|first3=Ralph M.|title=Histogenesis of brenner tumors, I: Histology and ultrastructure|journal=Cancer|volume=46|issue=12|year=1980|pages=2607–2616|issn=0008-543X|doi=10.1002/1097-0142(19801215)46:12<2607::AID-CNCR2820461213>3.0.CO;2-Q}}</ref><ref name="OutwaterSiegelman1998">{{cite journal|last1=Outwater|first1=Eric K|last2=Siegelman|first2=Evan S|last3=Kim|first3=Bohyun|last4=Chiowanich|first4=Peerapod|last5=Blasbalg|first5=Roberto|last6=Kilger|first6=Alex|title=Ovarian Brenner tumors: MR imaging characteristics|journal=Magnetic Resonance Imaging|volume=16|issue=10|year=1998|pages=1147–1153|issn=0730725X|doi=10.1016/S0730-725X(98)00136-2}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* >55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
:* In [[Ultrasound|US]] we may see hypoechoic solid [[Mass-to-charge ratio|mass]] and [[calcification]]
| style="background: #F5F5F5; padding: 5px;" |
* Hypointense on T2 because of [[fibrous]] content
| style="background: #F5F5F5; padding: 5px;" |
* Yellow/pale appearance
*[[Transitional cell]] [[tumor]] (resembles [[Urinary bladder|bladder]])
* Coffee bean [[nuclei]] on [[H&E stain|H&E]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Most of the times it's an accidental finding
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Krukenberg tumor]]<br><ref name="pmid8626898">{{cite journal |vauthors=Kim SH, Kim WH, Park KJ, Lee JK, Kim JS |title=CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors |journal=J Comput Assist Tomogr |volume=20 |issue=3 |pages=393–8 |date=1996 |pmid=8626898 |doi= |url=}}</ref><ref name="pmid17076540">{{cite journal |vauthors=Al-Agha OM, Nicastri AD |title=An in-depth look at Krukenberg tumor: an overview |journal=Arch. Pathol. Lab. Med. |volume=130 |issue=11 |pages=1725–30 |date=November 2006 |pmid=17076540 |doi=10.1043/1543-2165(2006)130[1725:AILAKT]2.0.CO;2 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" |
* >55 y/o
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  +/–
Based on underlying [[malignancy]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px; text-align: center;" |–
| style="background: #F5F5F5; padding: 5px;" |
* In case of [[Metastasis|metastatic]] [[Gastrointestinal cancer|GI cancers]] we may see [[iron deficiency anemia]] (IDA)
| style="background: #F5F5F5; padding: 5px;" |
* Mostly bilateral, complex ovarian [[lesion]]
* In [[CT scan]] we may see evidence of concurrent [[malignancy]] in other [[organs]]
| style="background: #F5F5F5; padding: 5px;" |
* Mostly bilateral, complex [[Ovary|ovarian]] [[lesion]] with solid components
* Internal hyperintensity on T1 and T2 weighted [[Mri|MR]] [[images]] because of [[Mucin 17|mucin]]
* Evidence of concurrent [[malignancy]] in other [[organs]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Mucin]]-secreting [[signet cell]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Imaging]]/<br>[[biopsy]]
|}


===Spinal Dermoid Cysts===
===Spinal Dermoid Cysts===
Line 38: Line 435:
*[[Metastases]] (cutaneous or lymph nodal lesions)  
*[[Metastases]] (cutaneous or lymph nodal lesions)  
*Cutaneous ectopic brain
*Cutaneous ectopic brain
*Lymphatic malformation
*[[Lymphatic]] malformation


==References==
==References==
Line 51: Line 448:
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[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Dermatology]]
[[Category:Surgery]]

Latest revision as of 12:47, 10 October 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]

Overview

Dermoid cyst must be differentiated from teratoma, as well as other common benign tumors that develop in the head and neck, ovaries, or spine (such as pilar cysts, steatocystoma, pilomatrixoma, encephalocele, vascular malformations, lipoleiomyoma, pilonidal cyst, and lipoma).[1][2][3][3][4]

Differential Diagnosis

Head and Neck

Dermoid cysts of head and neck must be differentiated from the following:[1][2]

Ovarian Dermoid Cysts


Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Age of onset Symptoms Physical examination
Lab Findings Imaging Immunohistopathology
Pelvic/abdominal pain or pressure Vaginal bleeding/discharge GI dysturbance Fever Tenderness CT scan/US MRI
Gynecologic
Ovarian Dermoid cyst
[5] 		+/– – – – +/–
  • cyst with no internal echo and with posterior acoustic enhancement
  • NA
Follicular cysts
[5] 		+/– – – – +/–
  • In US we may see a >3 cm simple cyst with no internal echo and with posterior acoustic enhancement
  • NA
Theca lutein cysts
[6][7][8] 		+/– – – – +/–
Serous cystadenoma/carcinoma
[9][10][11][12]
  • >55 y/o
 +/– – – – +/–
  • In US we may see simple or multiloculated cyst
  • In serous cystadenocarcinoma we may see papillary projection inside the cyst
  • In serous cystadenocarcinoma we may see ascites
  • We may see a simple cyst with beak sign, hypointense on T1 and hyperintense on T2
  • We may see some Solid malignant components inside the cyst with intermediate signal on T1 and T2
Mucinous cystadenoma/carcinoma
[13][14][15]
  • >55 y/o
 +/– – – – +/–
  • Stained glass appearance due to variable signal intensity on T1 and T2
  • The more mucin we have, there is more intensity on T1
  • and less intensity on T2
Endometrioma
[16][17][18] 		+ + +/– – +
  • hyperintensity on T1-weighted images and a hypointensity on T2-weighted images
  • Powder burn hemorrhages
Teratoma
[19][20][21][22]
  • 10-30 y/o
 +/– – – – +/–
  • We may see evidence of fat components
Dysgerminoma
[23][24]
  • in the second to third decade of life
 + +/– – – +/–
  • We may see ovarian mass with septation which are hyperintense on T1 and hypo or isointense on T2 imaging
  • Sheets fried egg appearance cells
Yolk sac tumor
[25][26][27] 		+ – – – +
  • High levels of AFP
  • In US we may see a combination of echogenic and hypoechoic components
  • Yellow appearance
  • Schiller-Duval bodies (glomeruli like structures)
Fibroma
[28][29][30]
  • >50 y/o
  • Pulling sensation in the groin
 – – – +/–
  • In CT scan we may see a unilateral mass with poor contrast enhancement
  • Low signal intensity on T1 and T2
Thecoma
[31][32][33]
  • >50 y/o
 +/– – – –
Granulosa cell tumor
[34][35][36][37]
  • 50-60 y/o
 + +/– – –
Sertoli-leydig cell tumor
[38][39]
  • 15 to 35 y/o
 +/– – – – –
  • In US we may see unilateral Well-defined hypoechoic lesion
  • Low T2 signal intensity
  • areas of high signal intensity
Brenner tumor
[40][41]
  • >55 y/o
 +/– – – – – –
  • Hypointense on T2 because of fibrous content
  • Most of the times it's an accidental finding
Krukenberg tumor
[42][43]
  • >55 y/o
 +/– – +/–

Based on underlying malignancy

– –

Spinal Dermoid Cysts

Others

Dermoid cysts must also be differentiated from the following:[44]

References

  1. ↑ 1.0 1.1 Ohta N, Watanabe T, Ito T, Kubota T, Suzuki Y, Ishida A; et al. (2012). "A case of sublingual dermoid cyst: extending the limits of the oral approach". Case Rep Otolaryngol. 2012: 634949. doi:10.1155/2012/634949. PMC 3465894. PMID 23056976.
  2. ↑ 2.0 2.1 Dermoid cyst. Wikipedia. https://en.wikipedia.org/wiki/Dermoid_cyst Accessed on February 4, 2016.
  3. ↑ 3.0 3.1 3.2 Sharma M, Mally R, Velho V (2013). "Ruptured conus medullaris dermoid cyst with fat droplets in the central canal [corrected]". Asian Spine J. 7 (1): 50–4. doi:10.4184/asj.2013.7.1.50. PMC 3596585. PMID 23508636.
  4. ↑ Intracranial dermoid cyst. Radiopaedia.org. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1 Accessed on February 5, 2016.
  5. ↑ 5.0 5.1 Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, Coleman B, Depriest P, Doubilet PM, Goldstein SR, Hamper UM, Hecht JL, Horrow M, Hur HC, Marnach M, Patel MD, Platt LD, Puscheck E, Smith-Bindman R (September 2010). "Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement". Radiology. 256 (3): 943–54. doi:10.1148/radiol.10100213. PMID 20505067.
  6. ↑ Montz FJ, Schlaerth JB, Morrow CP (August 1988). "The natural history of theca lutein cysts". Obstet Gynecol. 72 (2): 247–51. PMID 2455880.
  7. ↑ Southam, Anna L. (1962). "Massive Ovarian Hyperstimulation with Clomiphene Citrate". JAMA: The Journal of the American Medical Association. 181 (5): 443. doi:10.1001/jama.1962.03050310083018b. ISSN 0098-7484.
  8. ↑ Nguyen, K T; Reid, R L; Sauerbrei, E (1986). "Antenatal sonographic detection of a fetal theca lutein cyst: a clue to maternal diabetes mellitus". Journal of Ultrasound in Medicine. 5 (11): 665–667. doi:10.7863/jum.1986.5.11.665. ISSN 0278-4297.
  9. ↑ Jung, Seung Eun; Lee, Jae Mun; Rha, Sung Eun; Byun, Jae Young; Jung, Jung Im; Hahn, Seong Tai (2002). "CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis". RadioGraphics. 22 (6): 1305–1325. doi:10.1148/rg.226025033. ISSN 0271-5333.
  10. ↑ Imai, Shunsuke; Kiyozuka, Yasuhiko; Maeda, Hiroko; Noda, Tuneo; Hosick, Howard L. (1990). "Establishment and Characterization of a Human Ovarian Serous Cystadenocarcinoma Cell Line That Produces the Tumor Markers CA-125 and Tissue Polypeptide Antigen". Oncology. 47 (2): 177–184. doi:10.1159/000226813. ISSN 0030-2414.
  11. ↑ Malpica A, Deavers MT, Lu K, Bodurka DC, Atkinson EN, Gershenson DM, Silva EG (April 2004). "Grading ovarian serous carcinoma using a two-tier system". Am. J. Surg. Pathol. 28 (4): 496–504. PMID 15087669.
  12. ↑ Li J, Fadare O, Xiang L, Kong B, Zheng W (March 2012). "Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis". J Hematol Oncol. 5: 8. doi:10.1186/1756-8722-5-8. PMID 22405464.
  13. ↑ Hoerl HD, Hart WR (December 1998). "Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up". Am. J. Surg. Pathol. 22 (12): 1449–62. PMID 9850171.
  14. ↑ Lee KR, Scully RE (November 2000). "Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with 'pseudomyxoma peritonei'". Am. J. Surg. Pathol. 24 (11): 1447–64. PMID 11075847.
  15. ↑ Jung, Seung Eun; Lee, Jae Mun; Rha, Sung Eun; Byun, Jae Young; Jung, Jung Im; Hahn, Seong Tai (2002). "CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis". RadioGraphics. 22 (6): 1305–1325. doi:10.1148/rg.226025033. ISSN 0271-5333.
  16. ↑ Mol BW, Bayram N, Lijmer JG, Wiegerinck MA, Bongers MY, van der Veen F, Bossuyt PM (December 1998). "The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis". Fertil. Steril. 70 (6): 1101–8. PMID 9848302.
  17. ↑ Kinkel, Karen; Frei, Kathrin A.; Balleyguier, Corinne; Chapron, Charles (2005). "Diagnosis of endometriosis with imaging: a review". European Radiology. 16 (2): 285–298. doi:10.1007/s00330-005-2882-y. ISSN 0938-7994.
  18. ↑ de Ziegler, Dominique; Borghese, Bruno; Chapron, Charles (2010). "Endometriosis and infertility: pathophysiology and management". The Lancet. 376 (9742): 730–738. doi:10.1016/S0140-6736(10)60490-4. ISSN 0140-6736.
  19. ↑ Kawai, Michiyasu; Kano, Takeo; Kikkawa, Fumitaka; Morikawa, Yoshimitsu; Oguchi, Hidenori; Nakashima, Nobuo; Ishizuka, Takao; Kuzuya, Kazuo; Ohta, Masahiro; Arii, Yoshitaro; Tomoda, Yutaka (1992). "Seven tumor markers in benign and malignant germ cell tumors of the ovary". Gynecologic Oncology. 45 (3): 248–253. doi:10.1016/0090-8258(92)90299-X. ISSN 0090-8258.
  20. ↑ Dunzendorfer, Thomas; deLAS MORENAS, ANTONIO; Kalir, Tamara; Levin, Robert M. (1999). "Struma Ovarii and Hyperthyroidism". Thyroid. 9 (5): 499–502. doi:10.1089/thy.1999.9.499. ISSN 1050-7256.
  21. ↑ Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
  22. ↑ Saba, Luca; Guerriero, Stefano; Sulcis, Rosa; Virgilio, Bruna; Melis, GianBenedetto; Mallarini, Giorgio (2009). "Mature and immature ovarian teratomas: CT, US and MR imaging characteristics". European Journal of Radiology. 72 (3): 454–463. doi:10.1016/j.ejrad.2008.07.044. ISSN 0720-048X.
  23. ↑ Dgani, R.; Shoham(Schwartz), Z.; Czernobilsky, B.; Kaftori, A.; Borenstein, R.; Lancet, M. (1988). "Lactic dehydrogenase, alkaline phosphatase and human chorionic gonadotropin in a pure ovarian dysgerminoma". Gynecologic Oncology. 30 (1): 44–50. doi:10.1016/0090-8258(88)90044-3. ISSN 0090-8258.
  24. ↑ Tanaka YO, Kurosaki Y, Nishida M, Michishita N, Kuramoto K, Itai Y, Kubo T (1994). "Ovarian dysgerminoma: MR and CT appearance". J Comput Assist Tomogr. 18 (3): 443–8. PMID 8188914.
  25. ↑ Yang, Grace C.H. (2000). "Fine-needle aspiration cytology of Schiller-Duval bodies of yolk-sac tumor". Diagnostic Cytopathology. 23 (4): 228–232. doi:10.1002/1097-0339(200010)23:4<228::AID-DC2>3.0.CO;2-M. ISSN 8755-1039.
  26. ↑ Levitin, A; Haller, K D; Cohen, H L; Zinn, D L; O'Connor, M T (1996). "Endodermal sinus tumor of the ovary: imaging evaluation". American Journal of Roentgenology. 167 (3): 791–793. doi:10.2214/ajr.167.3.8751702. ISSN 0361-803X.
  27. ↑ Talerman, A.; Haije, W. G. (1974). "Alpha-fetoprotein and germ cell tumors: A possible role of yolk sac tumor in production of alpha-fetoprotein". Cancer. 34 (5): 1722–1726. doi:10.1002/1097-0142(197411)34:5<1722::AID-CNCR2820340521>3.0.CO;2-F. ISSN 0008-543X.
  28. ↑ MEIGS JV (May 1954). "Fibroma of the ovary with ascites and hydrothorax; Meigs' syndrome". Am. J. Obstet. Gynecol. 67 (5): 962–85. PMID 13148256.
  29. ↑ Sivanesaratnam, V.; Dutta, R.; Jayalakshmi, P. (1990). "Ovarian fibroma - clinical and histopathological characteristics". International Journal of Gynecology & Obstetrics. 33 (3): 243–247. doi:10.1016/0020-7292(90)90009-A. ISSN 0020-7292.
  30. ↑ Abad, Antonio; Cazorla, Eduardo; Ruiz, Fernando; Aznar, Ismael; Asins, Enrique; Llixiona, Joaquin (1999). "Meigs' syndrome with elevated CA125: case report and review of the literature". European Journal of Obstetrics & Gynecology and Reproductive Biology. 82 (1): 97–99. doi:10.1016/S0301-2115(98)00174-2. ISSN 0301-2115.
  31. ↑ Yaghoobian, Jahanguir; Pinck, Robert L. (1983). "Ultrasound findings in thecoma of the ovary". Journal of Clinical Ultrasound. 11 (2): 91–93. doi:10.1002/jcu.1870110207. ISSN 0091-2751.
  32. ↑ Li, Xinchun; Zhang, Weidong; Zhu, Guangbin; Sun, Congpeng; Liu, Qingyu; Shen, Yuechun (2012). "Imaging Features and Pathologic Characteristics of Ovarian Thecoma". Journal of Computer Assisted Tomography. 36 (1): 46–53. doi:10.1097/RCT.0b013e31823f6186. ISSN 0363-8715.
  33. ↑ Proctor, Francis E.; Greeley, Joseph P.; Rathmell, Thomas K. (1951). "Malignant thecoma of the ovary". American Journal of Obstetrics and Gynecology. 62 (1): 185–192. doi:10.1016/0002-9378(51)91109-X. ISSN 0002-9378.
  34. ↑ Pectasides D, Pectasides E, Psyrri A (February 2008). "Granulosa cell tumor of the ovary". Cancer Treat. Rev. 34 (1): 1–12. doi:10.1016/j.ctrv.2007.08.007. PMID 17945423.
  35. ↑ Stenwig, Jan Trygve; Hazekamp, Johan The.; Beecham, Jackson B. (1979). "Granulosa cell tumors of the ovary. A clinicopathological study of 118 cases with long-term follow-up". Gynecologic Oncology. 7 (2): 136–152. doi:10.1016/0090-8258(79)90090-8. ISSN 0090-8258.
  36. ↑ Morikawa K, Hatabu H, Togashi K, Kataoka ML, Mori T, Konishi J (1997). "Granulosa cell tumor of the ovary: MR findings". J Comput Assist Tomogr. 21 (6): 1001–4. PMID 9386298.
  37. ↑ Ko SF, Wan YL, Ng SH, Lee TY, Lin JW, Chen WJ, Kung FT, Tsai CC (May 1999). "Adult ovarian granulosa cell tumors: spectrum of sonographic and CT findings with pathologic correlation". AJR Am J Roentgenol. 172 (5): 1227–33. doi:10.2214/ajr.172.5.10227493. PMID 10227493.
  38. ↑ Lantzsch, T.; Stoerer, S.; Lawrenz, K.; Buchmann, J.; Strauss, H.-G.; Koelbl, H. (2001). "Sertoli-Leydig cell tumor". Archives of Gynecology and Obstetrics. 264 (4): 206–208. doi:10.1007/s004040000114. ISSN 0932-0067.
  39. ↑ Jung, Seung Eun; Rha, Sung Eun; Lee, Jae Mun; Park, Soo Youn; Oh, Soon Nam; Cho, Kyoung Sik; Lee, Eun Ju; Byun, Jae Young; Hahn, Seong Tai (2005). "CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary". American Journal of Roentgenology. 185 (1): 207–215. doi:10.2214/ajr.185.1.01850207. ISSN 0361-803X.
  40. ↑ Shevchuk, Maria M.; Fenoglio, Cecilia M.; Richart, Ralph M. (1980). "Histogenesis of brenner tumors, I: Histology and ultrastructure". Cancer. 46 (12): 2607–2616. doi:10.1002/1097-0142(19801215)46:12<2607::AID-CNCR2820461213>3.0.CO;2-Q. ISSN 0008-543X.
  41. ↑ Outwater, Eric K; Siegelman, Evan S; Kim, Bohyun; Chiowanich, Peerapod; Blasbalg, Roberto; Kilger, Alex (1998). "Ovarian Brenner tumors: MR imaging characteristics". Magnetic Resonance Imaging. 16 (10): 1147–1153. doi:10.1016/S0730-725X(98)00136-2. ISSN 0730-725X.
  42. ↑ Kim SH, Kim WH, Park KJ, Lee JK, Kim JS (1996). "CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors". J Comput Assist Tomogr. 20 (3): 393–8. PMID 8626898.
  43. ↑ Al-Agha OM, Nicastri AD (November 2006). "An in-depth look at Krukenberg tumor: an overview". Arch. Pathol. Lab. Med. 130 (11): 1725–30. doi:10.1043/1543-2165(2006)130[1725:AILAKT]2.0.CO;2. PMID 17076540.
  44. ↑ Intracranial dermoid cyst. Radiopaedia.org. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1 Accessed on February 5, 2016.


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