title: Sonographic features of incidentally detected, small, nonpalpable ovarian dermoids.
abstract: OBJECTIVE
  We describe the transvaginal sonographic features of incidentally detected, small, nonpalpable ovarian dermoid cysts.
  
  
  METHODS
  A total of 38 small (less than 3 cm in diameter), nonpalpable, incidentally discovered ovarian dermoids in 35 women were retrospectively reviewed; 3 patients had small bilateral lesions, and 7 had a small ovarian dermoid detected during preoperative evaluation of a symptomatic, large, contralateral lesion.
  
  
  RESULTS
  Transvaginal sonography permitted identification of all 38 dermoids, whereas abdominal sonography detected only 22 of the lesions. Three main structural patterns were observed with transvaginal sonography: (1) 20 of 38 lesions had a solid, hyperechoic appearance, either homogeneous (11) or heterogeneous (9); (2) a fluid-filled area with a hyperechoic focus in its wall was seen in 10 cases; and (3) a mixed pattern, with solid and liquid areas, was seen in 8 cases. Calcifications were appreciated in 7 lesions. Acoustic shadowing was noted in 30 cases, either as a shadow posterior to the hyperechoic portion of the mass or as an edge shadow lateral to the lesion. Doppler studies were obtained for 20 lesions but proved inconclusive: 4 mixed-pattern dermoids had a few internal signals with a low resistance pattern; in the remaining cases, there were signals at the periphery of the cysts, but it could not be determined whether these were from vessels within the lesions or from vessels in the surrounding ovarian parenchyma. Surgery confirmed benign cystic dermoids in all 38 cases.
  
  
  CONCLUSIONS
  Sonographically, small ovarian dermoids have a variety of textural patterns quite similar to those encountered in large, symptomatic lesions. The increased resolution capabilities provided by transvaginal sonography allow incidental detection of previously unsuspected dermoids and permit identification of their nature.
authors.affiliation: Servizio di Radiologia, Ospedale di Pietra Ligure, Via XXV Aprile 128, Pietra Ligure (SV) I-17027, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Serafini
authors.forename: P G
authors.initials: PG
authors.lastname: Quadri
authors.forename: N G
authors.initials: NG
authors.lastname: Gandolfo
authors.forename: N
authors.initials: N
authors.lastname: Gandolfo
authors.forename: C
authors.initials: C
authors.lastname: Martinoli
authors.forename: L E
authors.initials: LE
authors.lastname: Derchi
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color