title: Ovarian cystic teratoma with a pathognomonic appearance of multiple floating balls: a case report and investigation of common characteristics of the cases in the literature.
abstract: OBJECTIVE
  To investigate the common characteristics of a rare entity of ovarian cystic teratoma with intracystic floating balls in conjunction with a case.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 41-year-old woman with abdominal discomfort and a 2-year obscure history of an ovarian cyst.
  
  
  METHODS
  Right salpingo-oopherectomy by laparotomy.
  
  
  METHODS
  Ultrasonography and magnetic resonance imaging (MRI).
  
  
  RESULTS
  Ultrasonographic examination revealed a cystic mass (>10 cm) with a unique appearance of multiple floating balls on the lower right quadrant of the abdomen. The MRI showed the same balls with a slightly high fat content. Histopathological diagnosis was mature cystic teratoma and the balls were mostly made of keratin.
  
  
  CONCLUSIONS
  The appearance of intracystic floating balls is rarely seen but is pathognomonic for mature cystic teratoma. When this typical appearance is found on ultrasonography the value of other diagnostic tests, such as tumor markers, serological tests for echinococcosis, computerized tomography (CT), and MRI, can be considered as limited.
authors.affiliation: Department of Obstetrics and Gynecology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey. drgurel@yahoo.com
authors.forename: Hulusi
authors.initials: H
authors.lastname: Gürel
authors.forename: Sebahat Atar
authors.initials: SA
authors.lastname: Gürel
mesh_terms: D000328:Adult; D003884:Dermoid Cyst / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007633:Keratins / Q000032:analysis; D008279:Magnetic Resonance Imaging; D010048:Ovarian Cysts / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy; D013724:Teratoma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color
chemical_list: D007633:Keratins