Which descriptor is commonly used for a mature dermoid tumor on ultrasound?

• A. Tip of the iceberg
• B. Ring of fire
• C. Ground glass
• D. Striated pattern

Answer: (A)

A mature dermoid tumor commonly shows the tip of the iceberg sign on ultrasound. These teratomas often contain dense, fatty sebaceous material and hair, which are highly reflective and create strong acoustic echoes with posterior shadowing. That shadowing can obscure most of the interior of the cyst, so only the uppermost, brightest portion remains visible—much like the tip of an iceberg peeking above water. This distinctive appearance is why the descriptor is used for these lesions. Other terms describe different findings: a ground-glass appearance is typical of endometriomas, and Doppler “ring of fire” refers to vascularity around a lesion in other contexts; a striated pattern is not a classic hallmark of a mature dermoid.