1. Fetal Ovarian Dermoid Cyst
Shanti Shetty, Sanjeev Mani, Alpana
Karnik, Veena Louzado, Nikhil Cunha
Bandra Holy Family Hospital
Mumbai

2. Antenatal ultrasound - Cystic structure in the left adnexal region

3. Lesion is separate from the urinary bladder

4. Lesion reveals anechoic fluid content with echogenic dependant debris

6. USG Findings
• A transabdominal ultrasound scan was performed for
growth and measurements.
• Single viable IUP at 38w 3d.
• Placenta location - anterior
• Amniotic fluid - Normal
• Presentation of fetus - cephalic
• There is a relatively large ( 67 x 72 mm) cystic structure in
the left adnexal region, in close relation to the urinary
bladder, free from the stomach and the urinary bladder. It
reveals anechoic fluid content with echogenic debris that
sediments towards the dependant part.

7. Differential diagnosis
• Fetal ovarian dermoid cyst
• Twisted ovarian cyst

8. Discussion
• Dermoid cysts are the most common ovarian neoplasms
• They appear in the late 2nd/ 3rd trimester
• Their sizes range from small to 40 cm
• They are usually unilateral but upto 15% are bilateral
• Dermoid cysts contain fatty, sebaceous
material, hair, cartilage, bone and teeth.
• They demonstrate as a completely cystic mass, a cystic
mass with an echogenic mural nodule reperesenting a
dermoid plug, high amplitude echoes shadowing or a
complex mass with internal septation.
• The term ‘Tip of the iceberg’ refers to a mixture of matted
hair and sebum producing a ill-defined acoustic shadowing
that obscures the posterior wall of the lesion.

9. Management
• Continous ultrasound monitoring of
antenatally detected ovarian dermoid cysts is
recommended
• Induction of labour is considered if fetal lung
maturity is established

10. THANK YOU