Muhammad Nafees, Muhammad Hamid Akram, Seemin Nazad.
Dermoid cyst in an ectopic ovary.
Pak Armed Forces Med J Jan ;58(3):337-9.

A 30 years old lady, resident of Murree, presented with heaviness and dragging sensation in left lumbar region of 10 months duration. There were no urinary or bowel complaints. She had been married for 12 years and 10 months and had four children. The eldest child was 12 years old and youngest 03 months old. Her menstrual cycle was regular (3/30). The plain radiograph of abdomen showed a fat attenuation lesion in the left lumbar region. Its walls showed curvilinear calcification superiorly. There were multiple well formed teeth in it (fig. 1). Abdomino-pelvic ultrasound revealed a mass in left lumbar region, containing a solid hyperechoic component, suggesting the presence of fat. Some areas demonstrated acoustic shadowing, in keeping with a focus of calcification. The left ovary was not demonstrable in its normal adnexal location. The uterus and right ovary appeared normal. The findings of computed tomography of abdomen included an intraperitoneal, fat attenuation lesion in left lumbar region. It measured about 8.0 cm x 8.0 cm x 7.0 cm. It contained multiple rounded and ovoid calcific foci (the characteristic appearance of teeth was better seen on plain radiograph). Its walls showed focal curvilinear calcification. The lesion showed no contrast enhancement. Laboratory findings included haemoglobin-10.4 gm/dl, total leukocyte count; 12 x 109, Erythrocyte sedimentation rate, urine routine examination and blood sugar random were within normal limits. The tumor was resected and diagnosis of dermoid cyst confirmed on histopathology. Conventional radiography, ultrasound and computed tomography all contributed to clenching an accurate diagnosis.

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