Clinical Features:
A 39-year-old female patient came with lower abdominal pain.
Ultrasound Features:
- A well-defined, thin-walled, unilocular cystic lesion of about 9.1cm X 7.1cm size, casting posterior acoustic enhancement with smooth inner margin, no papillary projection or septation is noted arising from the left adnexa without a separately visualized left ovary.
- Numerous thin ‘echogenic lines & dots’ are seen within the fluid content forming the ‘dot dash pattern’ indicating the dermoid mesh.
- An echogenic component casting acoustic shadow is also noted within.
- Color Doppler shows no flow within the internal contents.
- No ascites or lymphadenopathy.
- O-RADS US 2, Color Score 1.
Remember:
- An adnexal cyst with internal echogenic components showing sound attenuation or casting acoustic shadows is a dermoid.
- Check for increased vascularity & ascites to exclude malignant transformation.
Ultrasound Diagnosis:
- Left adnexal dermoid cyst.
- O-RADS US 2, Color Score 1.
Ultrasound Images:
Transabdominal ultrasound showing uterus & left adnexal complex cyst
TVS showing cervical nabothian cyst
TVS showing enlarged right ovary
TVS showing left adnexal dermoid cyst
Color Doppler shows no flow within the internal contents
Reconstructed 3D images taken by regular TVS probe showing cyst cavity containing molar tooth
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