PMC6399541_01
Pelvic MRI showing a large mass confined to the pelvis measuring 7.2 cm in the largest diameter with predominance of cystic component without evidence of fatty content, calcification, fluid-fluid level, or suspicious enhancing nodular soft tissue thickening.
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fig1
The excised mass had well-circumscribed smooth borders and rubbery consistency. It is covered by a thin and focally congested membrane. It weighs 157g and measures 7.5cm x 5.5cm x 5.5cm. Cut surface shows unilocular cystic mass filled with beige brown soft material and hair shafts.
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fig2
It is covered by a thin membrane and is focally congested (Figure 2).
(a) & (b) Cystic cavity lined by orthokeratinized stratified squamous epithelium, with straight epithelial-connective tissue interface. Copious fibrillary keratin fills the cyst. (a) The base of a hair follicle is identified. (b) A sebaceous gland with adjacent arrector pili muscle fiber. (c) High power view of arrector pili muscle fiber. (d) A hair shaft found in the cystic wall. (e) Inflammatory reaction to keratin with multinucleated giant cells and foamy macrophages is seen. Absence of cartilage and bone in all figures.
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fig3
Pathology was consistent with mature cystic teratoma (Figure 3).