Ahmed Mussanna, Sawhney Mossum, Baranga Latika, Ali Nasser, Sullivan Robert
Department of Radiology, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, USA.
Department of Radiology, Kings County Hospital Center, Brooklyn, USA.
Cureus. 2022 Jun 17;14(6):e26035. doi: 10.7759/cureus.26035. eCollection 2022 Jun.
Ovarian neoplasms are categorized based on histopathologic features into epithelial surface cell tumors, germ cell tumors (teratomas), sex cord-stromal tumors, and metastases. Teratomas are the most common ovarian germ cell neoplasms. They are generally slow-growing lesions and can get fairly large before becoming symptomatic. The lesions are often incidentally discovered during imaging for other diagnostic purposes. Complications are uncommon but occur more commonly with larger lesions and include torsion, malignant degeneration, rupture, and rarely infection. When sizable, ovarian dermoid can rarely rupture and result in spillage of proteinaceous content into the peritoneal cavity, which can lead to chemical peritonitis. Additionally, the lesion can fragment into smaller lesions and can get implanted at different sites within the abdomen and pelvis. We present a case with an atypical presentation of a ruptured dermoid in a patient presenting with right upper quadrant pain who underwent sonographic evaluation, which demonstrated acute calculus cholecystitis but incidentally was found to have a partially calcified right subphrenic mass. Subsequent evaluation with computed tomography (CT) demonstrated multiple scattered peritoneal and mesenteric masses containing fat and calcification, highly suggestive of a chronically ruptured dermoid cyst.
卵巢肿瘤根据组织病理学特征可分为上皮性表面细胞瘤、生殖细胞肿瘤（畸胎瘤）、性索间质肿瘤和转移瘤。畸胎瘤是最常见的卵巢生殖细胞肿瘤。它们通常生长缓慢，在出现症状之前可能长得相当大。这些病变常在因其他诊断目的进行影像学检查时偶然发现。并发症并不常见，但在较大病变中更常发生，包括扭转、恶性变、破裂，很少发生感染。当卵巢皮样囊肿较大时，很少会破裂，导致含蛋白质的内容物溢入腹腔，可引起化学性腹膜炎。此外，病变可分裂成较小的病变，并可种植在腹部和盆腔的不同部位。我们报告一例表现不典型的破裂皮样囊肿病例，患者因右上腹疼痛接受超声检查，结果显示为急性结石性胆囊炎，但偶然发现右膈下有一局部钙化肿块。随后的计算机断层扫描（CT）检查显示，多个散在的腹膜和肠系膜肿块含有脂肪和钙化，高度提示为慢性破裂的皮样囊肿。
