CASE HISTORY: “Mary,” a 24-year-old woman, visits her gynecologist with a chief complaint of lower abdominal “fullness.” She describes it as a dull aching pain in her pelvic region and lower back. Intercourse is painful, and her menstrual periods have recently been irregular.

On pelvic exam, the physician detects a right ovarian mass, about the size of a hen’s egg. Pelvic ultrasound shows that the tumor has both solid and liquid components, with a dense spot of calcified matter.

An abdominal x-ray reveals a startling finding: Inside the tumor is a human tooth.

Perhaps the most bizarre of human tumors is the ovarian dermoid cyst, or mature teratoma. Usually found in young women, these weird tumors are not at all uncomoon, and account for about twenty percent of all ovarian tumors.

What makes dermoid cysts so fascinating (and truly creepy) is the fact they arise from the ovary’s germ cells — cells which are capable of developing into a complete fetus. A germ cell is the forerunner to all human tissues, and thus has the potential to become any organ or structure in the body. But instead of growing into a complete fetus, these cells form a disorganized mishmash of human tissues.

The cysts may contain clumps of hair, bone, skin, or sweat glands. Often there are pockets of sebum — a thick greasy fluid secreted by the skin’s sebaceous glands. Some tumors may even contain recognizable teeth!

The good news is, 99 percent of dermoid cysts are non-cancerous. Often they do not even cause symptoms and are first detected on routine pelvic examination.

The cure? surgical removal. But while some patients have been known to bring home their gallstones in a jar, this is one surgical souvenir you probably don’t want to display on the mantlepiece.

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