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1、JessicaWalter,HMSYearIIIGillianLieberman,MDNovember2012ACuttingEdgeOverviewofImagingOvarianDermoidsJessicaWalter,HarvardMedicalSchoolYearIIIGillianLieberman,MDJessicaWalter,HMSIIIGillianLieberman,MDAgenda•Background–Classification–Composition–Complications•Imaging–Ultrasound–CT–MRI•IndexPat
2、ientCoronalC-CT2CourtesyDr.RomeroJessicaWalter,HMSIIIGillianLieberman,MDOvarianDermoids:Classification•Maturecysticteratomas1–58%ofallovarianneoplasms–Broadagerangefavoringreproductiveyears,meanageis30yearsold–Mostoftenasymptomatic,ifsymptomatic,abdominalpainornonspecificsymptoms–Bilaterali
3、n12%ofpatients;ifunilateral73%occurontherightside–Slowgrowing(1.8mm/year)–Smallerinsizeatfirstdiagnosis(7cm)–Management:surveillanceiflessthan6cm–Localrecurrencefollowingsurgicalexcisionislessthan1%•Immatureteratomas2–Rare(lessthan1%ofallovarianteratomas)–Youngerpatients(20yearsofage)–Malig
4、nantbehavior;36%ofovariandermoidsthatbecomemalignant–Large(14-25cm),encapsulatedmassesthataremostlysolid,smallfocioffat,poorlydefinedcalcifications,hemorrhage–Serumalpha-fetoproteinincreasesin50%ofcases•MonodermalTeratomas(neuraltumors,strumaovarii,carcinoidtumors)2(1)Sabaetal.Matureandimma
5、tureovarianteratomas:CT,USandMRimagingcharacteristics.EuropeanJournalofRadiology.2009(2)Outwateretal,Ovarianteratomas:tumortypesandimagingcharacteristics.RadioGraphics2001.3JessicaWalter,HMSIIIGillianLieberman,MDOvarianDermoids:Composition•Fatinthecysticlumen–Presentin93%ofovariandermoids–M
6、ostspecificimagingfindingindicativeofMCT•Teethfoundin33%•Mesoderm90%•Ectoderm–Skinandneuraltissue•Endoderm–Thyroidandgastrointestinaltissue4Sabaetal,Matureandimmatureovarianteratomas:CT,USandMRimagingcharacteristics.EuropeanJournalofRadiology.2009JessicaWalter,HMSIIIGillianLieberman,MDOvari
7、anDermoids:Complications•Rupture:leakageofliquefiedsebaceouscontentsintotheperitoneumthatcausesgranulomatousperitonitis(rare,lessthan1%ofallcases)1•Torsion–Ovariandermoidsincreaseinsizefollowingtorsion1–Morecommoninpregnancy•Ovarianveinthrombophlebitis:s
