Multiple globules in a cystic ovarian teratoma.
OBJECTIVE
To describe the characteristic imaging findings of multiple globules and globules-fluid level in a cystic ovarian teratoma.


METHODS
Descriptive case study.


METHODS
Mackay Memorial Hospital and National Yang-Ming University, Taipei, Taiwan, Republic of China.


METHODS
A 20-year-old woman with left abdominal discomfort and a palpable mass on the left side of the distended abdomen.


METHODS
Surgical removal of a 10-cm cystic ovarian teratoma that contained chocolate-like fluid and multiple spheroid mobile globules consisting of yellowish sebaceous debris and fine hair shafts.


METHODS
Plain abdominal radiography, ultrasonography, and computed tomography (CT).


RESULTS
Plain abdominal radiography revealed no calcification in the mass. The first sonographic examination showed no movement by positional change of multiple rounded echogenic masses ranging from 0.5 cm to 2 cm in diameter, but the second CT examination done after the patient had spent some time lying down showed that the rounded masses arrayed in the upper portion of the cyst and displayed the characteristic level of globules-fluid. Thus, the differential diagnosis was multiple mobile globules in a cystic ovarian tumor.


CONCLUSIONS
This case indicates that fatty masses need time to float upward in the fluid matrix of a cystic ovarian teratoma. This delayed effect should be considered when an ovarian cyst with multiple rounded echogenic masses is diagnosed by ultrasonography, CT, or magnetic resonance imaging.
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan. cpc_mmh@yahoo.com
C P
CP
Chen
S R
SR
Chern
W
W
Wang
K L
KL
Wang
T Y
TY
Wang
D015746:Abdominal Pain; D000328:Adult; D020420:Cyst Fluid; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology; D010173:Palpation; D011859:Radiography; D013724:Teratoma / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography