Solution: Ovarian dermoids are a congenital benign germ cell tumor containing mature tissues from all three germ cell layers. Since the ectodermal components tend to predominate, there is often hair, skin, fat, and calcified teeth-like structures in the mass. They are the most common ovarian neoplasm. They can rarely undergo malignant degeneration into squamous cell carcinoma, but more pertinently, they can predispose the patient to ovarian torsion or rupture with a chemical peritonitis. Therefore, they are generally surgically resected. In this case, the new cluster of calcifications in the left lower quadrant was felt to be concerning for teeth within a teratoma and the patient had an US to confirm that this was indeed a dermoid.