This patient went on to have surgical resection of the larger lesions which was confirmed to have ruptured.
Histology
MACROSCOPIC DESCRIPTION: A solid nodule 40mm in diameter with a fatty cut surface and hair tufts attached to its outer surface. Sectioning reveals bony tissue embedded within the fat (?tooth).
MICROSCOPIC DESCRIPTION: Sections show a mature cystic teratoma which predominantly consists of adnexal structures and skin. However there is a small amount of mature glial tissue present. No immature elements are seen.
FINAL DIAGNOSIS: Mature cystic teratoma with majority of elements in keeping with a dermoid cyst. Focal mature glial tissue. No immature elements.