Multimodality Imaging Approach to Ovarian Neoplasms with Pathologic Correlation

Abstract

Ovarian neoplasms can be categorized on the basis of histopathologic features into epithelial surface cell tumors, germ cell tumors, sex cord-stromal tumors, and metastases. While their imaging appearance is often nonspecific, it closely parallels the gross pathologic appearance, and radiologic-pathologic correlation is helpful to aid in a deeper understanding of the subtypes. Epithelial cell neoplasms are the most common category, and they can be benign, borderline, or malignant. Specific subtypes include serous (most common), mucinous, seromucinous, endometrioid, clear cell, Brenner, and undifferentiated. High-grade serous cystadenocarcinoma accounts for the majority of malignant ovarian tumors and the most ovarian cancer deaths. While serous neoplasms are often unilocular and bilateral, mucinous neoplasms are larger, unilateral, and multilocular. Solid components, thickened septa, and papillary projections, particularly with vascularity, indicate borderline or malignant varieties. Endometrioid and clear cell carcinomas can arise within endometriomas. Fibrous tumors (cystadenofibroma, adenofibroma, fibroma or fibrothecoma, and Brenner tumors) demonstrate low T2-weighted signal intensity of their solid components, while teratomas contain lipid. The nonspecific imaging appearance of additional malignant ovarian germ cell tumors can be narrowed with tumor marker profiles. Sex cord-stromal tumors are often solid, and secondary signs from their hormonal secretion can be a clue to their diagnosis. The authors review the anatomy of the ovary and distal fallopian tube, the proposed origins of the histologic subtypes of tumors, the clinical features and epidemiology of ovarian neoplasms, and the applications of US, CT, and MRI in imaging ovarian neoplasms. The main focus is on the radiologic and pathologic features of the multiple ovarian neoplasm subtypes. An algorithmic approach to the diagnosis of ovarian neoplasms is presented.

Mesonephric‐like adenocarcinoma of the ovary in an elderly woman: A case report and a review of the literature

“…Since fibrous tumors of the ovary are usually benign neoplasms such as fibroma, Brenner's tumor, and adenofibroma, solid component with T2-low signal is considered to be the imaging finding suggestive of benignity. 15 However, in our case, the solid component of the tumor showed a low signal intensity on T2WI. This finding is unusual for a malignant ovarian epithelial tumor.…”

Brenerio Naviko Radiologinės Diagnostikos Ypatumai. Klinikinis Atvejis

“…Gerybiniai navikai gali būti 5-6 cm skersmens, išskirtiniais atvejais gali siekti 10 cm [7]. Ribinio piktybiškumo ir piktybinių Brenerio navikų diametras gali siekti net iki 30 centimetrų [8].…”

“…Magnetinio rezonanso tyrimo vaizduose Brenerio naviko gausūs fibrotiniai komponentai ir kalcifikacijos matomi kaip ryškiai hipointensiniai T2 režime [8,10]. Be to, šis navikas paprastai yra žemesnio intensyvumo signalo T2 režime nei kiti solidiniai tumorai [8]. Apie 20 proc.…”

“…Tokiais atvejais cistinis komponentas reprezentuoja gleivinės cistinį tumorą, o solidinis komponentas -Brenerio naviką [11]. Vaizdas tokiais atvejais taip pat yra labai žemo intensyvumo signalo T2 režime [8,10,11].…”

Mucinous Cystadenocarcinoma in Breast: Complicated with Lymph Node, Thoracic Wall Metastasis, and Contralateral Triple Negative Breast Cancer: A Case Report

“…Mucinous cystadenocarcinoma (MCA) is a very rare breast tumor. This type of tumor mainly occurs in the ovaries [1] . To our knowledge, almost only 32 relevant literature have been published in National Center for Biotechnology Information (NCBI) database so far, mostly focusing on the pathologic and radiographic ndings since rst authoritatively introduced at 1998 [2,3,4,5] .…”