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Forty patients with pelvic masses were examined with ultrasound; surgical exploration subsequently revealed an ovarian teratoma. The echographic appearance of the lesions was extremely variable. Although a number of characteristic features of teratomas have been described (axial location, solid mural component, acoustic shadow, and "hair/fluid level"), these occurred only in a minority (17/40) of patients. When the clinical setting suggests an ovarian teratoma, the ultrasonographer should consider it regardless of the internal architecture and consistency of the mass.

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