Differences in ultrasound features of papillations in unilocular‐solid adnexal cysts: a retrospective international multicenter study

Landolfo, Chiara; Valentin, Lil; Franchi, D.; Holsbeke, C. Van; Fruscio, Robert; Froyman, Wouter; Sladkevicius, P.; Kaijser, Jeroen; Ameye, Lieveke; Bourne, Tom; Savelli, L.; Coosemans, An; Testa, Antonia Carla; Timmerman, Dirk

doi:10.1002/uog.18951

Cited by 25 publications

(21 citation statements)

References 31 publications

(44 reference statements)

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“…The finding that anechoic spaces in papillary projections was associated with malignancy is surprising in view of microcystic appearance of papillary projections being so common (38.6%) in the serous cystadenofibromas in our study. However, not all benign lesions in the study by Landolfo et al . were serous cystadenofibromas, which constituted only 29% of the benign lesions.…”

Section: Discussionmentioning

confidence: 83%

“…A published retrospective analysis of 204 unilocular solid cysts with papillary projections, but no other solid components, showed that shadowing behind papillary projections was more often present in benign than in borderline or malignant cysts, while papillary projections with anechoic spaces were more often present in borderline or malignant cysts than in benign cysts, i.e. in 60% vs in 24%. The finding that anechoic spaces in papillary projections was associated with malignancy is surprising in view of microcystic appearance of papillary projections being so common (38.6%) in the serous cystadenofibromas in our study.…”

Section: Discussionmentioning

confidence: 99%

“…were serous cystadenofibromas, which constituted only 29% of the benign lesions. Moreover, the study of Landolfo et al . included only cysts with one cyst locule and no solid components other than papillary projections.…”

Section: Discussionmentioning

confidence: 99%

“…(a) Serous cystadenofibroma in a 61‐year‐old patient, appearing as a unilocular‐solid cyst with a papillary projection but no other solid components. (b) Stage‐IA endometrioid carcinoma in an 86‐year‐old patient, appearing as a unilocular‐solid cyst with a solid component that is not a papillary projection (reproduced from Landolfo et al …”

mentioning

confidence: 99%

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Imaging in gynecological disease (16): clinical and ultrasound characteristics of serous cystadenofibromas in adnexa

Virgilio

Blasis

Sladkevicius

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To describe the clinical and ultrasound characteristics of serous cystadenofibromas in the adnexa. Methods This was a retrospective study of patients identified in the International Ovarian Tumor Analysis (IOTA) database, who had a histological diagnosis of serous cystadenofibroma and had undergone preoperative ultrasound examination by an experienced ultrasound examiner, between 1999 and 2012. In the IOTA database, which contains data collected prospectively, the tumors were described using the terms and definitions of the IOTA group. In addition, three authors reviewed, first independently and then together, ultrasound images of serous cystadenofibromas and described them using pattern recognition. Results We identified 233 women with a histological diagnosis of serous cystadenofibroma. In the IOTA database, most cystadenofibromas (67.4%; 157/233) were described as containing solid components but 19.3% (45/233) were described as multilocular cysts and 13.3% (31/233) as unilocular cysts. Papillary projections were described in 52.4% (122/233) of the cystadenofibromas. In 79.5% (97/122) of the cysts with papillary projections, color Doppler signals were absent in the papillary projections. Most cystadenofibromas (83.7%; 195/233) manifested no or minimal color Doppler signals. On retrospective analysis of 201 ultrasound images of serous cystadenofibromas, using pattern recognition, 10 major types of ultrasound appearance were identified. The most common pattern was a unilocular solid cyst with one or more papillary projections, but no other solid components (25.9%; 52/201). The second most common pattern was a multilocular solid mass with small solid component(s), but no papillary projections (19.4%; 39/201). The third and fourth most common patterns were multi‐ or bilocular cyst (16.9%; 34/201) and unilocular cyst (11.9%; 24/201). Using pattern recognition, shadowing was identified in 39.8% (80/201) of the tumors, and microcystic appearance of the papillary projections was observed in 34 (38.6%) of the 88 tumors containing papillary projections. Conclusions The ultrasound features of serous cystadenofibromas vary. The most common pattern is a unilocular solid cyst with one or more papillary projections but no other solid components, with absent color Doppler signals. Most serous cystadenofibromas were poorly vascularized on color Doppler examination and many manifested acoustic shadowing. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Imaging in gynecological disease (16): clinical and ultrasound characteristics of serous cystadenofibromas in adnexa

Virgilio

Blasis

Sladkevicius

et al. 2019

Ultrasound in Obstet & Gyne

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“…In our series, only 47.8% of BOTs had papillary projections ≥ 3 mm on imaging; this discrepancy is most likely to be due to slight differences in the definition of papillae. One study, that of Landolfo et al 31 , provided an extensive sonographic evaluation of papillae in unilocular-solid adnexal cysts, describing '11 ultrasound features of papillations and the cyst wall', including the number of papillae, their height in millimeters, their contour, the presence of intrapapillary blood flow, the percent of papillary dissemination, the papillary angle relative to the inner cyst wall and the echogenicity of the projections, and describing the acoustic shadows cast by the papillae. They highlighted that there were 'anechoic spaces present in at least one papilla' in 62% of BOTs and 58% of malignant entities.…”

Section: Discussionmentioning

confidence: 99%

New sonographic marker of borderline ovarian tumor: microcystic pattern of papillae and solid components

Timor‐Tritsch

Foley

Brandon

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To describe and evaluate the utility of a new sonographic microcystic pattern, which is typical of borderline ovarian tumor (BOT) papillary projections, solid component(s) and/or septa, as a new ultrasound marker that is capable of distinguishing BOT from other adnexal masses, and to present/obtain histologic confirmation. Methods In this retrospective study, we identified women with a histologic diagnosis of BOT following surgical resection who had undergone preoperative transvaginal ultrasound (TVS) examination. All images were reviewed for presence or absence of thin-walled, fluid-filled cluster(s) of 1-3-mm cystic formations, associated with solid component(s), papillary projections and/or septa. From the same cases, histopathologic slides of each BOT were examined for presence of any of these microcystic features which had been identified on TVS. To confirm that the microcystic TVS pattern is unique to BOTs, we also selected randomly from our ultrasound and surgical database 20 cases of epithelial ovarian cancer and 20 cases of benign cystadenoma, for review by the same pathologists. To confirm the novelty of our findings, we searched PubMed for literature published in the English language between 2010 and 2018 to determine whether the association between microcystic tissue pattern and BOT has been described previously. Results Included in the final analysis were 62 patients (67 ovaries) with preoperative TVS and surgically confirmed BOT on pathologic examination. The mean patient age at surgery was 39.8 years. The mean BOT size at TVS was 60.7 mm. Of the 67 BOTs, 47 (70.1%) were

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Ovarian Masses: The Value of Acoustic Shadowing on Ultrasound Examination

Yoeli-Bik

Lengyel

Mills

et al. 2022

J of Ultrasound Medicine

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Adnexal lesions are a common finding in women and pose a clinical challenge since ovarian cancer is a highly lethal disease. However, most adnexal masses are benign, benefiting from a more conservative approach. In preoperative assessment, transvaginal ultrasound plays a key role in evaluating morphologic features that correlate with the risk of malignancy. The acoustic shadow is the loss of echo behind sound-absorbing components, such as calcifications or fibrous tissues, which are predominantly found in benign lesions. However, recognizing the acoustic shadow is a difficult skill to master, and its usefulness may be underappreciated.

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Differences in ultrasound features of papillations in unilocular‐solid adnexal cysts: a retrospective international multicenter study

Abstract: We have identified ultrasound features that can help to discriminate between benign and malignant unilocular-solid cysts with papillations but no other solid components. Our results need to be confirmed in prospective studies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Cited by 25 publications

References 31 publications

Imaging in gynecological disease (16): clinical and ultrasound characteristics of serous cystadenofibromas in adnexa

Imaging in gynecological disease (16): clinical and ultrasound characteristics of serous cystadenofibromas in adnexa

New sonographic marker of borderline ovarian tumor: microcystic pattern of papillae and solid components

Ovarian Masses: The Value of Acoustic Shadowing on Ultrasound Examination

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