Sonographic Diagnosis of a Mature Cystic Teratoma Resulting in Acute Torsion

Mature cystic teratomas are benign germ cell tumors and, depending on the size, may be at risk for torsion. These ovarian masses can cause the ovarian vasculature to twist upon itself and inhibit blood flow, resulting in partial to complete torsion. If detection and treatment are not prompt, a salpingo-oophorectomy may be needed impeding future fertility. This case describes a young woman with acute left adnexal pain where sonography aided in the diagnosis of ovarian torsion caused by a large mature cystic teratoma. Transabdominal sonography was used, aided by extended field-of-view technology for characterization of the mass. The sonographic attributes of mature cystic teratomas vary, but careful evaluations can lead to an accurate diagnosis to aid in surgical procedures. The patient underwent an exploratory laparotomy, which resulted in a left ovary oophorectomy and excision of the mass.