“Dots and dashes” (Fig. 1) metaphorically describe the classic sonographic appearance of echogenic hair within mature cystic teratomas (Fig. 2). Mature cystic teratomas, also known as dermoid cysts, are composed of at least two of the three germ cell layers (endoderm, mesoderm, and ectoderm) and represent the most common germ cell neoplasm [1]. Most mature cystic teratomas can be diagnosed by ultrasound (with a reported sensitivity of 58% and specificity of 99%) [2]. In indeterminate cases, these lesions sometimes require further characterization by CT (Fig. 3) or MR to confirm an internal fat component [3].
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