Routine diagnosis of teratoma

Mature teratomas contain thyroid tissue. SO refers to teratomas that are all or mainly composed of thyroid tissue (simple or mixed SO), which is a rare ovarian tumor. The vast majority of SO occur in women of childbearing age, with the peak incidence around 50 years old. It is more common on one side, with no obvious difference between the left and right sides, and can occur on both sides. The routine diagnosis of teratomas is mainly ultrasound diagnosis.

Pathophysiology

1. The teratoma is medium-sized, round or oval, and unilocular;

2. Contains oil or hair, sometimes teeth and bone fragments;

3. On the cyst wall, there are nipple-like structures protruding into the cyst cavity, which are called scolex;

4. Teratomas may contain endoderm, mesoderm, and ectoderm, and occasionally have monodermal structures, forming ovarian goiter (case attached below).

Ultrasound manifestations

Internal echoes are related to the composition: high echoes or strong echoes (mostly fat, hair or teeth), often irregular in shape, attached to one side of the teratoma wall; low echoes (liquid part);

Fat stratification sign, dough sign, wall nodule sign, chaotic structure sign, waterfall sign or weeping willow sign.

CDFI: It is difficult to detect blood vessels inside and around the tumor, and there is little or no blood flow signal.

Cases and Ultrasound

Exploration revealed: no ascites in the abdominal cavity, the uterus was anterior, slightly atrophied, regular in shape, smooth in surface, with a myoma of about 3×3×2cm3 on the anterior wall; the left ovary was enlarged to about 7×6×6cm3, with an irregular surface, multiple nodules, solid, hard, with an intact capsule, incarcerated in the rectouterine pouch, and no obvious abnormality in the appearance of the left fallopian tube; the right ovary was atrophied, forming a membranous adhesion with the peritoneum, and the fallopian tube had no abnormality in appearance; after the exploration, the left ovarian tumor was resected, and a frozen biopsy was sent during the operation, which indicated that it was benign, and a routine hysterectomy + bilateral oophorectomy was performed.