OP17.03: Variation in the morphological appearance of ovarian mature cystic teratomas: Implications for diagnosis and management

Abstract

Objectives: Mature cystic teratomas (MCT) or Dermoid cysts of the ovary account for approximately 25% of all ovarian tumours. The wide range of tissue types found in these tumours give rise to a highly varied appearance on ultrasound examination. The aim of this study was to assess the frequency of different morphological features in order to improve the accuracy of ultrasound diagnosis and aid in management planning. Methods: Our gynaecology ultrasound database and the histopathology department were retrospectively searched for MTCs. All women with a histological diagnosis of MCT and preoperative ultrasound images were included in the study. The images were reviewed by a single observer who recorded the presence and extent of common and rare features of MCTs. Results: A total of 133 cysts were found in 117 women. 15/117 (12.8%) had bilateral MCTs. Hyperechoic cyst contents consistent with sebum were present in 94.7% of cysts. Other common ultrasound features included hair (91.7%), acoustic shadowing (83.5%), and healthy ovarian tissue seen at one edge of the cyst (‘‘the ovarian crescent sign’’) 75.9%. The amount of sebum within the cyst was significantly higher in older women and it was inversely proportional to the size of the cyst (P < 0.05). Conclusions: Sebum and hair are present in more than 90% of MCTs, which facilitates a correct pre-operative diagnosis on ultrasound scan. The amount of sebum within the cyst can be used to estimate the potential of the cyst to grow and require surgical intervention in the future.