Borderline cystic tumors of the ovary: Gray‐scale and color Doppler sonographic findings

Pascual, M.; Tresserra, F.; Grases, Pedro; Labastida, R; Dexeus, S

doi:10.1002/jcu.10028.abs

Cited by 12 publications

(24 citation statements)

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“…This is not surprising because we found that these ultrasound features are characteristic of borderline tumors, and borderline tumors were overrepresented among the difficult tumors. Others, too, found papillary projections and multilocularity to be characteristic of borderline tumors 6,7 . It is important to be able to reliably discriminate between benign and malignant adnexal masses in order to be able to correctly evaluate the need for surgery and to choose the appropriate time and mode of operation.…”

Section: Discussionmentioning

confidence: 99%

Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis?

Valentin

Ameye

Jurkovic

et al. 2006

Ultrasound in Obstet & Gyne

154

115

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Section: Discussionmentioning

confidence: 99%

Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis?

Valentin

Ameye

Jurkovic

et al. 2006

Ultrasound in Obstet & Gyne

154

115

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show abstract

“…1, 2) had very similar sonographic features, a smaller diameter, fewer locules, higher numbers of papillary excrescences, and higher color scores inside solid components than mucinous BOTs of intestinal types [83]. They often manifest as unilocular-solid or multilocular-solid tumors with irregular and perfunded papillary projections without other signs of complexity, such as a solid pattern, irregular septae, and irregular inner walls due to tumor deposits in young women [81][82][83][84][85][86]. Their cyst fluid can be anechoic or have low-level or ground-glass echogenicity.…”

Section: Diagnosismentioning

confidence: 97%

“…There are also cases of purely unilocular smooth cysts being histologically serous or mucinous BOTs; the incidence of such findings ranged between 3.5% and 11.4% depending on the size of the tumor [83][84][85]. Papillary projections are more common in borderline tumors than in invasive cancer, but they may also be seen in benign tumors (e.g., serous cystadenomas, serous cystadenofibromas, endometriomas) and lead to many false-positive ultrasound diagnoses of malignancy, particularly to diagnoses of BOTs [85][86][87][88][89]. In comparison with their benign counterparts (serous cystadenomas), serous borderline tumors have usually more numerous, larger (1-10 mm in greatest dimension), and softer papillations.…”

Section: Diagnosismentioning

confidence: 99%

“…The lack of muscular elements results in a low resistance to blood flow and arteriovenous anastomoses give high pressure gradients, resulting in high-velocity blood flow. But the studies revealed no specific Doppler flow indices currently available to diagnose BOTs [85,86]. The absence of perfusion in the solid portion of tumor, with no detectable vessels in color Doppler, may represent a marker of benign tumor.…”

Section: Diagnosismentioning

confidence: 99%

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Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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After completing this course, the reader will be able to:1. Compare the epidemiologic and reproductive risk factors in BOTs with those in ovarian cancers and describe the molecular background of development of BOTs.2. Use the pathological terminology with either original grouping of borderline category or new subclassification of BOTs and assess the major predictor of recurrence and survival.3. Determine an appropriate diagnostic algorithm for patients with symptoms suggesting malignant ovarian tumors that will identify borderline ovarian tumors when present.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBorderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (lowgrade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type-easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. The Oncologist

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“…A truly malignant-appearing mass, based on mixed echogenicity, several papillary protrusions of more than 2 to 3 mm containing visible blood vessels, [4][5][6][7] and at times larger areas of solid components with bizarre, irregular vessels with changing calibers and occasional vascular "lakes." 8 More examples could be given, but these sufficiently illustrate the issue.…”

mentioning

confidence: 99%

The Complexity of a “Complex Mass” and the Simplicity of a “Simple Cyst”

Timor‐Tritsch

Goldstein

2005

Journal of Ultrasound in Medicine

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ynecologic sonography has made considerable strides in the last 20 years. Initially, the resolution of abdominal transducers increased. Then transvaginal probes were introduced, were perfected, and have become the principal tools for evaluating the female pelvis. Correlations of sonographic images with pathologic findings have led to a substantial understanding of adnexal abnormalities. In fact, you could say, the field collectively has a learning curve just as individuals have a learning curve. The development of scoring systems to characterize and define ovarian lesions first based on morphologic characteristic and later including color Doppler flow data brought us closer to a relatively reliable distinction between benign and malignant lesions or at least a negative predictive value in the range of 97% to 99%. 1-3Despite the above achievements, it is disheartening to see today some gynecologic sonographic reports that may have been appropriate 20 years ago when resolution was more limited, as was our field's level of understanding. We frequently see, in reports of a gynecologic patient, the wording "a left adnexal complex mass measuring 4 × 5 × 4 cm was seen." We desperately look for a more detailed description of the finding-in vain, because there is none. Then we search for the results of a Doppler study of the vessels in or around the finding. Again, none are reported. The most alarming message comes at the end of the report in the paragraph entitled "Impression," where we see a long list of differential diagnoses, which invariably end with the statement, ". . . ovarian malignancy cannot be ruled out." Looking at the pictures on which these reports are issued, we can often see benign-appearing adnexal lesions such as corpora lutea, cystic teratomas, endometriomas, and even simple cysts. Much of the time, however, the diagnosis can be made with a great deal more accuracy than the clinician is currently getting. We agree that not all hemorrhagic corpora lutea, endometriomas, or benign cystic teratomas are "classic" in their sonographic appearance, but most of them are distinctive enough. Therefore, this practice of giving a differential diagnosis that includes virtually every adnexal abnormality is no longer appropriate. As a field we can do better-most of the time.What should the referring provider do reading such a report? When the adnexal mass was detected at the palpatory examination, the gynecologist knew all too well the differential diagnoses pertaining to this mass, including the possibility of cancer. The patient was sent for the sonographic scan for help in the diagnostic process, not for the purpose of reading the list of diagnoses the gynecologist knew in the first place. Imaging laboratories can and should do better much of the time.

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Borderline cystic tumors of the ovary: Gray‐scale and color Doppler sonographic findings

Cited by 12 publications

References 0 publications

Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis?

Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis?

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

The Complexity of a “Complex Mass” and the Simplicity of a “Simple Cyst”

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