Solution: The initial plain film shows calcifications in the pelvis that have an unusual configuration. If you look closely, you will see that they have an appearance somewhat reminiscent of teeth. This is suspicious for a dermoid/teratoma, but should be confirmed. The patient then had an US, which shows a complex cystic mass that is consistent with a cystic dermoid. No blood flow is seen in the mass and although it is not definitive, the lack of blood flow and symptoms are concerning for an ovarian dermoid and associated torsion. This patient went on to a confirmatory MRI,



















which showed typical findings, confirming the presence of fat on the in and out of phase images. The patient went to surgery and there was 720 torsion of the ovary with an associated 9 cm mature teratoma.