A 16-year-old presents with acute abdomen. Ultrasound shows a 7 cm right ovarian mass with areas of calcification and fat density. Serum AFP and β-hCG are normal; LDH is mildly elevated. The MOST likely diagnosis is:

• A Mature cystic teratoma (dermoid cyst) ✓
• B Dysgerminoma
• C Endodermal sinus tumour
• D Immature teratoma

Explanation

Mature cystic teratoma is the most common ovarian tumour in young women and adolescents. It characteristically contains fat (echogenic foci with acoustic shadowing on ultrasound), calcifications (teeth, bone), and is the most common benign germ cell tumour. AFP and β-hCG are negative, which rules out endodermal sinus tumour and choriocarcinoma. Dysgerminoma elevates LDH markedly and typically lacks fat/calcification.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.