This 17 y/o female presented with a history of previous left pelvic pain and left adnexal mass of eight months duration. Selected trans-abdominal and trans-vaginal ultrasound images shown above demonstrate a complex cystic/solid mass with the solid component predominating. A dermoid cyst was suggested in the differential diagnosis. Surgical excision and subsequent histology confirmed the diagnosis of mature cystic teratoma/dermoid cyst with ectodermal, mesodermal and endodermal derivatives. On gross examination, sebaceous material admixed with hair was seen. This may account for the "frond like" pattern seen on the transvaginal images. It is interesting to note the increased information about the internal architecture/anatomy of the mass when comparing the trans-abdominal images above with the trans-vaginal images below.
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