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Dermoid cyst of ovary: A dermoid cyst of the ovary — also called a mature cystic teratoma — is one of the most common benign ovarian tumors, usually seen in young women of reproductive age. It arises from germ cells and contains tissues from all three germ layers (ectoderm, mesoderm, and endoderm). #ultrasound #medicaleducation #sonography #diagnosticultrasound #ultrasoundcases #ultrasoundlearning #medicalultrasound #ultrasoundcasestudy #ultrasoundtraining #radiology General Appearance: Usually unilateral, well-defined, round or oval cystic mass. Size varies — can be small or very large . Commonly heterogeneous internal echoes due to mixed contents -fat, hair, calcifications. Sonographic Sign Description Echogenic nodule -Rokitansky nodule or dermoid plug-Solid protuberance projecting into cyst lumen — contains hair, teeth, or fat. Tip of the iceberg sign Dense echogenic area with posterior acoustic shadowing, obscuring posterior wall — due to sebaceous material and hair. Dermoid mesh / hair strands Multiple fine linear echogenic interfaces within the cyst (floating hair). Fat-fluid or fluid-fluid level Caused by layering of sebaceous material over serous fluid. Calcifications / teeth Bright echogenic foci with shadowing. Differential Diagnosis: Hemorrhagic cyst Endometrioma chocolate cyst Cystic teratocarcinoma -if malignant features present Mucinous cystadenoma -if multiloculated and mucin-filled Complications: Torsion -most common — due to heavy contents Rupture — may cause chemical peritonitis Infection (rare) Malignant transformation -rare, less than 2% Key Points: Benign in more than 95% of cases Common in young reproductive women (20–40 years) Often asymptomatic, found incidentally on ultrasound Managed surgically -laparoscopic cystectomy preferred if symptomatic or large