YUSMAFAZIELA BT YUSOF

08-3-223
GROUP C SECTION 6
PATHOLOGY: DERMOID CYSTS, OVARY

A. Brief Descriptions：
1. Benign cystic teratoma (dermoid cyst) is the most common ovarian neoplasm ,
comprising up to 25% or more of all ovarian tumors.
2. Account for 15% of ovarian neoplasm, 10% bilateral
3. It is the most common benign ovarian tumor.
4. Contain various mature tissues derived from one or more of the embryonic
germ layers : the ectoderm, mesoderm, and endoderm.
5. Occur at any age,with a peak incidence in the first two decades of life

B. Gross Findings：
1. Cystic mass containing thick sebaceous material and hairs.
2. The internal lining is smooth but frequently has a knob-like nodular protrusion
in one.
3. Area (the “umbo”), in which cartilage, bone, and well-formed teeth may be
present.
 C. Micro Findings：
1. The cyst is lined by skin, including hair follicles and other skin appendages;
other elements often include bone,tooth,cartilage,adng gastrointestinal, neurologic,
respiratory, and thyroid gland tissues
2. Skin element (dermal appendages, e.G. Hair follicles, sebaceous glands).
3. Endodermal element (respiratory and gastrointestinal epithelia).
4. Mesodermal element (muscle, fat, cartilage).
5. Glial element.

Cystic mass containing heterogeneous Dermoid component seen.

component
Sebaceous gland, adipose tissue, epithelial Skin elements seen
component, and cartilage are seen in this view

Ciliated epithelium seen in left view Skin element (dermal appendages)

D. Others:
• The clinical manifestation of this slow growing lesion is usually related to its size,
compression, or torsion or to a chemical peritonitis secondary to intraabdominal spill of rate
of the cholesterol-laden debris. Infection is an uncommon complication of mature cystic
teratoma.

• Radiology: US- Solid and cystic ovarian mass with multiple interfaces, fat/fluid
levels, multiple thin meshlike structures (hair), hyperechoic lesion with posterior
shadowing (Calcium - tooth/bone), tip of the iceberg sign.

• Prognosis and Treatment: recommend cross-sectional imaging for further evaluation

(differentiation from neoplasm). Typically surgically resected, as torsion is most
common complication. Malignant transformation occurs in 3% of cases.
References:
- Sytemic Pathology Part II 3rd Edition by Members of Pathology Department, Alexandria
faculty of Medicine
- Lippincott Wlliams & Wilkins Pathology by Arthur S. Schneider, Philip A. Szanto
- http://pathology.class.kmu.edu.tw/ch06/Slide38.htm
- http://www.theprofesional.com/article/3rd-edition/Prof-1453.pdf
- http://www.humpath.com/spip.php?article4398
- http://rad.usuhs.edu/medpix/parent.php3?mode=single&recnum=9266#Dig Deeper