Imaging in gynecological disease (22): clinical and ultrasound characteristics of ovarian embryonal carcinomas, non‐gestational choriocarcinomas and malignant mixed germ cell tumors

Moro, Francesca; Castellano, L.; Franchi, D.; Epstein, Elisabeth; Fischerová, D.; Froyman, Wouter; Timmerman, Dirk; Zannoni, Gianfranco; Scambia, Giovanni; Valentin, Lil; Testa, Antonia Carla; Mascilini, F.

doi:10.1002/uog.23529

Cited by 7 publications

(2 citation statements)

References 45 publications

(76 reference statements)

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“…In the Imaging in Gynecological Disease series of this Journal (see virtual issue https://obgyn .onlinelibrary.wiley.com/doi/toc/10.1002/(ISSN)1469-0705.imagingingynecologicaldisease), the ultrasound appearance of different benign and malignant ovarian tumors is described based on retrospective analysis of ultrasound images. Several ovarian malignancies have been found to manifest a typical appearance on ultrasound, making it possible for the ultrasound examiner to suggest a specific diagnosis, for example granulosa cell tumor 23 , dysgerminoma 24 , yolk sac tumor 25 , endometrioid cancer 26 , clear cell cancer 27 , Krukenberg tumor 28 , ovarian embryonal carcinoma, non-gestational choriocarcinoma or malignant mixed germ cell tumor 29 . However, in this study, we were unable to identify an ultrasound pattern specific for ovarian carcinosarcoma that could distinguish it from, for example, high grade serous ovarian carcinoma, which is the most common ovarian malignancy 4,30 .…”

Section: Discussionmentioning

confidence: 99%

Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma

Ciccarone

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Moro

et al. 2022

Ultrasound in Obstet & Gyne

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Objective To describe the clinical and ultrasound characteristics of ovarian carcinosarcoma. Methods This was a retrospective multicenter study. Patients with a histological diagnosis of ovarian carcinosarcoma, who had undergone preoperative ultrasound examination between 2010 and 2019, were identified from the International Ovarian Tumor Analysis (IOTA) database. Additional patients who were examined outside of the IOTA study were identified from the databases of the participating centers. The masses were described using the terms and definitions of the IOTA group. Additionally, two experienced ultrasound examiners reviewed all available images to identify typical ultrasound features using pattern recognition. Results Ninety‐one patients with ovarian carcinosarcoma who had undergone ultrasound examination were identified, of whom 24 were examined within the IOTA studies and 67 were examined outside of the IOTA studies. Median age at diagnosis was 66 (range, 33–91) years and 84/91 (92.3%) patients were postmenopausal. Most patients (67/91, 73.6%) were symptomatic, with the most common complaint being pain (51/91, 56.0%). Most tumors (67/91, 73.6%) were International Federation of Gynecology and Obstetrics (FIGO) Stage III or IV. Bilateral lesions were observed on ultrasound in 46/91 (50.5%) patients. Ascites was present in 38/91 (41.8%) patients. The median largest tumor diameter was 100 (range, 18–260) mm. All ovarian carcinosarcomas contained solid components, and most were described as solid (66/91, 72.5%) or multilocular‐solid (22/91, 24.2%). The median diameter of the largest solid component was 77.5 (range, 11–238) mm. Moderate or rich vascularization was found in 78/91 (85.7%) cases. Retrospective analysis of ultrasound images and videoclips using pattern recognition in 73 cases revealed that all tumors had irregular margins and inhomogeneous echogenicity of the solid components. Forty‐seven of 73 (64.4%) masses appeared as a solid tumor with cystic areas. Cooked appearance of the solid tissue was identified in 28/73 (38.4%) tumors. No pathognomonic ultrasound sign of ovarian carcinosarcoma was found. Conclusions Ovarian carcinosarcomas are usually diagnosed in postmenopausal women and at an advanced stage. The most common ultrasound appearance is a large solid tumor with irregular margins, inhomogeneous echogenicity of the solid tissue and cystic areas. The second most common pattern is a large multilocular‐solid mass with inhomogeneous echogenicity of the solid tissue. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

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Section: Discussionmentioning

confidence: 99%

Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma

Ciccarone

Biscione

Moro

et al. 2022

Ultrasound in Obstet & Gyne

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“…Bleeding is the most often reported presentation of NGOC [30], including non-gynecologic bleeding such as profound hematochezia in a patient who had metastatic disease involving the intestines [22]. As a result, patients often have severe anemia requiring multiple blood transfusions or massive transfusion protocols [22,31]. In one case report, a patient received 19 blood transfusions in the year prior to her diagnosis [3].…”

Section: Clinicalmentioning

confidence: 99%

Non-Gestational Ovarian Choriocarcinoma: A Rare Ovarian Cancer Subtype

et al. 2022

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Non-Gestational Ovarian Choriocarcinoma (NGOC) is an extremely rare ovarian tumor, with an incidence of less than 0.6% of malignant ovarian germ cell tumors. Its close pathologic resemblance to Gestational Ovarian Choriocarcinoma (GOC), however, requires special attention as the treatments differ greatly. NGOC typically affects patients in late adolescence or early reproductive years. As a result, NGOCs are often misdiagnosed as ectopic pregnancies due to their common presentation of bleeding, abdominal pain, adnexal mass, and positive serum beta-HCG. On pathologic examination, the tumor is indistinguishable from GOC, and only after review of tissue for paternal genetic components can the diagnosis of NGOC be made. Imaging studies often show highly vascular lesions with further investigation with computer topography (CT) sometimes showing metastatic lesions in the lungs, pelvis, vagina, and liver. These lesions are often hemorrhagic and can lead to catastrophic bleeding. Treatment is vastly different from GOC; NGOC requires treatment with both surgical resection and chemotherapy, with Bleomycin, Etoposide, and Cisplatin (BEP) being the most used regimen. With correct diagnosis and treatment, patients can often receive fertility sparing treatment with long term survival.

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Rare occurrence of ovarian choriocarcinoma: ultrasound evaluation

Youssef

2024

J Ultrasound

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Imaging in gynecological disease (22): clinical and ultrasound characteristics of ovarian embryonal carcinomas, non‐gestational choriocarcinomas and malignant mixed germ cell tumors

Cited by 7 publications

References 45 publications

Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma

Imaging in gynecological disease (23): clinical and ultrasound characteristics of ovarian carcinosarcoma

Non-Gestational Ovarian Choriocarcinoma: A Rare Ovarian Cancer Subtype

Rare occurrence of ovarian choriocarcinoma: ultrasound evaluation

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