Sack of marbles sign (dermoid cyst)
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The sack of marbles sign refers, also known as the marbles in a bag sign, refers to aggregations of multiple small globules of fat within a cyst mimicking marble spheres within a sack. They appear hyperechoic on ultrasound, fat attenuation on CT, and high signal on T1WI and T2WI on MRI. It is considered highly suggestive of a dermoid cyst in the head and neck region 1-7. The term has also been used to describe ovarian dermoid cysts 8,9, although the floating balls sign is a more commonly used descriptor in this region.
-<p>The <strong>sack of marbles sign</strong> refers to aggregations of multiple small globules of fat within a cyst mimicking marble spheres within a sack. They appear hyperechoic on ultrasound, fat attenuation on CT, and high signal on T1WI and T2WI on MRI. It is considered highly suggestive of a <a href="/articles/dermoid-cyst">dermoid cyst</a> <sup>1</sup>.</p>- +<p>The <strong>sack of marbles sign</strong>, also known as the <strong>marbles in a bag sign</strong>, refers to aggregations of multiple small globules of fat within a cyst mimicking marble spheres within a sack. They appear hyperechoic on ultrasound, fat attenuation on CT, and high signal on T1WI and T2WI on MRI. It is considered highly suggestive of a <a href="/articles/dermoid-cyst">dermoid cyst</a> in the head and neck region <sup>1-7</sup>. The term has also been used to describe ovarian dermoid cysts <sup>8,9</sup>, although the <a title="Floating balls sign" href="/articles/floating-balls-sign">floating balls sign</a> is a more commonly used descriptor in this region.</p>
References changed:
- 3. Mirza S, Fadl S, Napaki S, Abualruz A. Case report of complicated epidermoid cyst of the floor of the mouth: Radiology-histopathology correlation. (2014) Qatar medical journal. 2014 (1): 12-6. <a href="https://doi.org/10.5339/qmj.2014.2">doi:10.5339/qmj.2014.2</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25320687">Pubmed</a> <span class="ref_v4"></span>
- 4. Lin HW, Silver AL, Cunnane ME, Sadow PM, Kieff DA. Lateral dermoid cyst of the floor of mouth: unusual radiologic and pathologic findings. (2011) Auris, nasus, larynx. 38 (5): 650-3. <a href="https://doi.org/10.1016/j.anl.2011.01.002">doi:10.1016/j.anl.2011.01.002</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/21334151">Pubmed</a> <span class="ref_v4"></span>
- 5. Giarraputo L, Savastano S, D'Amore E, Baciliero U. Dermoid Cyst of the Floor of the Mouth: Diagnostic Imaging Findings. (2018) Cureus. 10 (4): e2403. <a href="https://doi.org/10.7759/cureus.2403">doi:10.7759/cureus.2403</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29872584">Pubmed</a> <span class="ref_v4"></span>
- 6. Otonari-Yamamoto M, Nakajima K, Sakamoto J, et al. Atypical MRI and Histopathological Findings in Dermoid Cyst. (2018) The Bulletin of Tokyo Dental College. 59 (3): 207-212. <a href="https://doi.org/10.2209/tdcpublication.2017-0044">doi:10.2209/tdcpublication.2017-0044</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30224615">Pubmed</a> <span class="ref_v4"></span>
- 7. Fujimoto N, Fujii N, Nagata Y, et al. Dermoid cyst with magnetic resonance image of sack-of-marbles. (2008) The British journal of dermatology. 158 (2): 415-7. <a href="https://doi.org/10.1111/j.1365-2133.2007.08321.x">doi:10.1111/j.1365-2133.2007.08321.x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18047514">Pubmed</a> <span class="ref_v4"></span>
- 8. Wang A, Shu Y. Mature ovarian cystic teratoma with "sack of marbles" appearance on magnetic resonance imaging: A case report. (2019) Medicine. 98 (31): e16691. <a href="https://doi.org/10.1097/MD.0000000000016691">doi:10.1097/MD.0000000000016691</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31374057">Pubmed</a> <span class="ref_v4"></span>
- 9. Lee KH. 'Sack of marbles' in mature cystic ovarian teratoma. (2017) Abdominal radiology (New York). 42 (5): 1616-1617. <a href="https://doi.org/10.1007/s00261-017-1059-x">doi:10.1007/s00261-017-1059-x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28138731">Pubmed</a> <span class="ref_v4"></span>
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