A case report of a mature cystic teratoma composed with all three germ layers

We describe a case of a mature cystic teratoma (MCT) of the ovary with solid and cystic components derived from all three germ layers (ectoderm, endoderm and mesoderm) in a 44-year-old woman. This patient presented with non-specific abdominal discomfort and abdominal bloating for couple of years. Pelvic ultrasound scan (USS) showed of a large complex ovarian tumour with a CA 125 level of 74U/ml. The calculated risk malignancy index (RMI) was high therefore a total abdominal hysterectomy and saphingo-opherectomy and partial omentectomy was done. Macroscopically left ovary was enlarged with a nodular cystic mass. The cut surface shows a multilocular cyst filled with mucoid fluid. Some loculi contain hair and sebaceous material. Microscopically the solid areas of the cyst wall were largely composed of thyroid tissue (10%), rest of the cyst wall contains mature skin adnexal structures including hair, salivary glands, adipose tissue, bone, lymphoid tissue and smooth muscle.