title: Numerous intracystic floating balls as a sonographic feature of benign cystic teratoma: report of 5 cases.
abstract: OBJECTIVE
  The purpose of this series was to describe the unusual but unique sonographic pattern of mature cystic teratoma.
  
  
  METHODS
  Five patients of reproductive age with clinical manifestations of a pelvic mass were evaluated with sonography for treatment planning.
  
  
  RESULTS
  All 5 cases showed the similar sonographic pattern of a large cystic tumor filled with multiple echogenic spherical structures floating in the cystic background. Of the 5 patients, 3 had rather large balls varying in size between 1 and 4 cm in the same tumor masses, whereas the other 2 had numerous smaller balls of about 0.5 cm in diameter. The numerous crowded very small echogenic balls in the last 2 cases mimicked solid nodules representing malignancy. However, there was no vascularization in the balls, which suggested a benign nature. The postoperative pathologic diagnosis was mature cystic teratoma without any malignant component in all cases.
  
  
  CONCLUSIONS
  The sonographic feature of intracystic floating echogenic balls is probably pathognomonic for mature teratoma and is easily detected in most cases. Color Doppler sonography is helpful in differentiating these benign nodules (small balls) from malignant tumors.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. ttongson@mail.med.cmu.ac.th
authors.forename: Theera
authors.initials: T
authors.lastname: Tongsong
authors.forename: Chanane
authors.initials: C
authors.lastname: Wanapirak
authors.forename: Surapan
authors.initials: S
authors.lastname: Khunamornpong
authors.forename: Kornkanok
authors.initials: K
authors.lastname: Sukpan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D013724:Teratoma / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography