Ultrasound in diagnosing a dermoid cyst - A case study

Suzzanna Leeming, Radiology, Sheffield Teaching Hospitals


Dermoid cysts are the most common benign ovarian germ cell tumour and make up 10-20% of ovarian neoplasms (Rathore et al. 2017). This case report illustrates the use of gynaecological ultrasound in the diagnosis of a dermoid cyst in a young, premenopausal female with abdominal pain.

Case Report

A nulliparous, premenopausal, 21 year old female attended the ultrasound department for a pelvic scan as requested by her General Practitioner (GP). The request read: “Lower abdominal pain, very tender. History of ovarian cysts in home country of Albania”. The patient was a victim of human trafficking and was unable to communicate her symptoms and history. There were no prior biochemical tests.

The transabdominal scan revealed there was a complex, unilocular mass of mixed echogenicity measuring 22mm in the right ovary. The transvaginal examination verified the right ovarian mass consisted of solid components, hyperechoic stranded echoes and demonstrated acoustic shadowing. The right ovarian mass was reported as a dermoid cyst and a gynaecological referral was recommended. The dermoid cyst was not causing any acute symptoms at the time and the patient is currently undergoing expectant management.


Ultrasound has a high sensitivity in diagnosing dermoid cysts. Despite this dermoid cysts can have a varied appearance which makes the diagnosis challenging. The images demonstrated multiple, thin echogenic striations within which may represent hair and posterior acoustic shadowing likely caused by calcified components within the mass. These appearances have previously been described as typical ultrasound characteristics of a dermoid cyst. Using the IOTA simple rules also deterred suspicions of malignancy. Whilst laparoscopic surgery is the preferred management, conservative management for smaller dermoid cysts is accepted. In this case ultrasound alone was able to efficiently conclude and diagnose a dermoid cyst.

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