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Imaging Findings of Complications and Unusual Manifestations of Ovarian Teratomas¹

¹ From the Department of Radiology, Research Institute of Radiology (S.B.P., J.K.K., K.S.C.), and Department of Pathology (K.R.K.), Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, South Korea. Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received April 9, 2007; revision requested July 26 and received November 16; accepted March 20, 2008. All authors have no financial relationships to disclose. Address correspondence to J.K.K. (e-mail: rialto{at}amc.seoul.kr).

Ovarian teratomas can be associated with various complications and demonstrate a wide spectrum of clinical and imaging features. The complications include torsion (16% of ovarian teratomas), rupture (1%–4%), malignant transformation (1%–2%), infection (1%), and autoimmune hemolytic anemia (<1%). These complications require different therapeutic strategies; therefore, timely and accurate diagnosis of these complications is important for optimal patient treatment. In cases of complicated ovarian teratomas, the clinical manifestations provide only limited information and often overlap with those of other diseases. Furthermore, ovarian teratomas may have unusual clinical and imaging manifestations, thereby leading to misdiagnosis. These unusual manifestations include immature teratomas, monodermal teratomas (struma ovarii), combination tumors and collision tumors containing teratomas, and mature cystic teratomas without demonstrable fat or with pure fatty components. To provide adequate treatment and prevent misdiagnosis, it is necessary to be familiar with the imaging findings of both the complications and the unusual manifestations of ovarian teratomas.

© RSNA, 2008