Incidental Finding on Spine MRI

45-year-old female presented for spine MRI.

Figure 1. Shows T2W image and cyst appearing hyperintense.

Figure 2. Shows T2W image and cyst appearing hyperintense.

Figure 3. T1 image shows curvilinear hyperintense areas. Rest of contents are slightly hyperintense on T1.

Figure 4. STIR image shows suppression of signal in curvilinear T1 hyperintense areas suggestive of fat content.

Figure 5A. CT image shows average density of contents less than 0 suggestive of fat content.

Figure 5B. CT image shows average density of contents less than 0 suggestive of fat content.

A pelvic cystic mass was incidentally picked up on MRI.

Plain radiograph may show calcific and tooth components within the pelvis.

On Color Doppler: no internal vascularity; internal vascularity requires further workup to exclude a malignant lesion

CT has high sensitivity in the diagnosis of cystic teratomas though it is not routinely recommended for this purpose owing to its ionizing radiation.

MR evaluation usually tends to be reserved for difficult cases but is exquisitely sensitive to fat components.

Ovarian dermoid cyst and mature cystic ovarian teratoma are terms often used interchangeably to refer to the most common ovarian neoplasm.

Mature cystic teratomas account for ~15% (range 10%-20%) of all ovarian neoplasms.

Mature cystic teratomas are encapsulated tumors with mature tissue or organ components.

Mature ovarian teratomas are slow growing (1-2 mm a year) and, therefore, some advocate nonsurgical management. Larger lesions are often surgically removed.

General differential imaging considerations includeHemorrhagic ovarian cyst.