Clinical History:
- A right adnexal mass was discovered in a 23 year-old woman, who was being evaluated for infertility. On abdominal x-ray, calcification was noted in the region of the right ovary. A CT scan revealed bilateral ovarian masses that were both cystic and solid. At laparotomy, the right ovary was 13 cm and the left ovary 7 cm in greatest dimension, and their external surfaces were smooth.
- What is the diagnosis and prognosis?
This is a mature cystic teratoma (the less accurate but often used term is "dermoid cyst") because it is cystic and a teratoma has tissues derived from all three embryonic layers (ectoderm, endoderm, mesoderm). You can probably find the following tissues: epidermis, sebaceous glands, hair follicles, apocrine glands, fat, ovarian stroma, and ganglion cells. There is no evidence of primitive embryonic-type tissue (immature teratoma), nor is there evidence of malignant transformation of the mature tissues, so the prognosis is excellent.
- What sorts of things can you find in this lesion?
Tissues representing any of the three germ layers can be seen. In general, ectodermal components (skin with hair) predominate. Sometimes you can even see a tooth. An unusual component in rare cases is a significant amount of thyroid, which can function and lead to the condition known as struma ovarii, with hyperthyroidism.
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