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This is a patient who underwent CT in

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the second trimester of pregnancy at

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18 weeks' gestation after suffering a trauma.

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She was involved in a motor vehicle accident.

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We have axial CT images of the abdomen and

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pelvis, which are contrast-enhanced, and we can

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see the gravid uterus with a posteriorly located

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placenta and an early second trimester fetus.

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The placenta and its relationship

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to the myometrium are normal,

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without any intervening hyperdensity

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to suggest a placental abruption.

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One of the first things that we notice

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in the right hemiabdomen, alongside

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the uterus, is a cystic lesion, which

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is arising from the left ovary.

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We can see that it has a thin septation

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as well as a small calcification and some

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relatively isodense or hyperdense material in

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addition to a crescent of lower density fluid.

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There is an additional mass present in

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the left adnexa, which is arising from the

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left ovary. We can see a slice of normal

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ovarian tissue here, in addition to this

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fat- and calcium-containing left adnexal

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mass with a small adjacent cystic component.

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On coronal imaging, we can again see

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this complex cystic right ovarian

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mass, which is displaced superiorly

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into the right upper quadrant because

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of the size of the gravid uterus.

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So remember that structures which

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may typically be located low in the

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pelvis may ascend and become displaced

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laterally as the uterus enlarges.

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We can also see nicely on our coronal

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view this fat- and calcium- and fluid-

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containing left ovarian lesion.

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And so this patient has both a complex right

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ovarian cyst and a mature ovarian teratoma

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in the right and left ovaries, respectively.