Imaging of Ovarian Teratomas in Children: A 9-Year Review

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Imaging of Ovarian Teratomas in Children: A 9-Year Review Mohammed O.S. Alotaibi, MD, Oscar M. Navarro, MD Canadian Association of Radiologists Journal Volume 61, Issue 1, Pages 23-28 (February 2010) DOI: 10.1016/j.carj.2009.07.001 Copyright © 2010 Terms and Conditions

Figure 1 Immature ovarian teratoma in a 12-year-old girl with lower abdominal mass. (A) Transverse US scan of the pelvis shows a well-defined adnexal solid mass with linear echogenic areas (arrow) suggestive of calcification. (B) Colour Doppler US interrogation reveals vascularity of the adnexal mass. (C) Axial enhanced CT image shows a solid pelvic mass of predominantly low attenuation with linear calcification. Canadian Association of Radiologists Journal 2010 61, 23-28DOI: (10.1016/j.carj.2009.07.001) Copyright © 2010 Terms and Conditions

Figure 2 Mature ovarian teratoma in a 14-year-old girl who presented with an abdominal mass. (A) Coronal and (B) sagittal reformatted CT images show a large, multiloculated, predominantly cystic mass that extends from the pelvis into the upper abdomen, with scalloping of the liver surface, and calcification, with a fatty component anteriorly. (C) Axial CT image of the abdomen shows infiltration of the left parietocolic gutter (arrow) and (D) axial CT image of the abdomen reveals a fat-fluid level and calcification in the right subhepatic region. At surgery, a ruptured ovarian teratoma was found. Canadian Association of Radiologists Journal 2010 61, 23-28DOI: (10.1016/j.carj.2009.07.001) Copyright © 2010 Terms and Conditions

Figure 3 Right ovarian torsion in a 14-year-old girl. Colour Doppler US scan of the right adnexum shows a predominantly solid inhomogeneous lesion with many hypoechoic regions and no detectable internal flow. Torsion of the right ovary was found at surgery because of underlying teratoma of an immature type. Canadian Association of Radiologists Journal 2010 61, 23-28DOI: (10.1016/j.carj.2009.07.001) Copyright © 2010 Terms and Conditions

Figure 4 Metastatic immature ovarian teratoma in a 17-year-old girl. (A) Contrast-enhanced axial CT image of the upper abdomen shows 2 well-defined hypodense lesions in the right lobe of the liver, which are of fat density and do not show significant enhancement with contrast material. (B) Coronal in-phase time of echo (TE) = 4.2 ms and (C) coronal out-of-phase (TE = 1.8 ms) MR images of the liver, confirm the fatty nature of these nodules by revealing high signal intensity on the in-phase image (B), which drops significantly on the out-of-phase image (C). Immature ovarian teratoma metastasis was confirmed at biopsy. Canadian Association of Radiologists Journal 2010 61, 23-28DOI: (10.1016/j.carj.2009.07.001) Copyright © 2010 Terms and Conditions

Figure 5 Classic US appearance of mature ovarian teratoma, which demonstrates a cystic adnexal lesion with intracavitary echogenic nodule (arrow), the latter is often referred to as a dermoid plug or Rokitansky nodule. Canadian Association of Radiologists Journal 2010 61, 23-28DOI: (10.1016/j.carj.2009.07.001) Copyright © 2010 Terms and Conditions

Figure 6 Left ovarian teratoma found on periodic follow-up in a 16-year-old girl with history of right oophorectomy for torted ovarian teratoma. (A) Axial T1-weighted and (B) unenhanced fat-suppressed axial T1-weighted images show multiple well-defined, small, rounded lesion of high signal intensity on (A) (arrow), and low signal intensity on the fat suppressed images (B) within the left ovary, consistent with a fat-containing lesion, which, in the ovary, is highly suggestive of teratoma. Canadian Association of Radiologists Journal 2010 61, 23-28DOI: (10.1016/j.carj.2009.07.001) Copyright © 2010 Terms and Conditions