Dermoid cyst CT

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

Overview

CT

Ovarian Dermoid Cyst

  • Although dermoid cysts and teratomas in the ovary have histological differences (a dermoid is composed only of epidermal elements, whereas teratomas have mesodermal and endodermal elements), the imaging findings are very similar.[1]
  • CT scan may be helpful in the diagnosis of ovarian dermoid cyst. Findings on CT scan suggestive of ovarian dermoid cyst include:[2][3]
    • 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:[1]
    • 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:[4][1]
    • Hypoattenuating fatty fluid below the right hemidiaphragm which is a pathognomonic finding
    • The leaked contents from the cyst may result in a chemical peritonitis.

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:[5]
    • 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. 1.0 1.1 1.2 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma Radiopedia. Accessed on February 11, 2016
  2. 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.
  3. 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.
  4. 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.
  5. Intracranial dermoid cyst. http://radiopaedia.org/articles/intracranial-dermoid-cyst-1. Accessed on February 11, 2016.


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