Tumor markers and mature cystic teratoma of the ovary

Ovarian mature cystic teratoma (MCT, dermoid cyst) is the most common benign tumor of the ovary in women during the reproductive age.1–3 The majority of ovarian MCT can be easily diagnosed by image tools, including ultrasound, computed tomography and magnetic resonance images.4,5 Among these tools, ultrasound might be one of the most powerful tools because of its convenience, its increasing advanced technology and cost-effectiveness.6,7 The typical features of ovarian MCT includes (1) Rokitansky nodule (dermoid plus), presented by shadowing echodensity-a densely echogenic tubercule projecting into the cystic lumen; (2) dot-dash sign, presented by hyperechoic lines and dots arising from hairs in different orientations within the imaging plane; (3) intratumor fat, presented by diffuse or regional high amplitude echoes; (4) tooth/calcification, presented by regional high amplitude echoes wit shadowing; (5) chemical shift artifact; (6) tuft or hair, presented by diffuse or regional high amplitude echoes; (7) intratumoral keratinoid material; and (8) the other rare features, such as palm tree-like protrusion, comet tail appearance, floating balls sign, fat-fluid/fluid–fluid level, and tip of the iceberg sign.

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