Serous carcinoma of the ovary: CT identification of metastatic calcified implants.

Abstract

The metastasis along peritoneal surfaces of serous cystadenocarcinoma, the most common ovarian malignancy, occurs early and is present in most patients at the time of clinical diagnosis. In many patients, however, computed tomography (CT) is unable to demonstrate peritoneal metastases because of their small size and similarly has been unable to demonstrate metastases in normal sized lymph nodes. Serous cystadenocarcinoma contains histologic calcification in approximately 30% of cases; thus, CT scans were retrospectively reviewed in 15 patients with pathologically proved stage III or IV disease to detect calcified peritoneal metastases. Six patients had calcified peritoneal implants, five of which had perihepatic calcifications. One of the five also had calcified lymphatic metastases, some of which were in normal sized nodes. In three of these five, the examination was otherwise normal. Search for these calcifications should improve the sensitivity of CT in diagnosing metastases from ovarian carcinoma.

Calcified metastases from ovarian carcinoma highlighted by F-18 FDG PET/CT: report of two cases

“…The incidence of radiologically visible calcification in primary ovarian adenocarcinoma and metastasis is documented between 8 and 15.7% [1][2][3]. Metastases from ovarian carcinoma occur due to peritoneal, lymphatic, or hematogenous spread of tumor, with the peritoneal implants being the most common and rarely hematogenous spread.…”

“…Calcifications occurring in ovarian recurrence and metastases are not uncommon; the prevalence of calcified ovarian metastasis is about 8-15.7% [1][2][3]. Although anatomic imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI) are the mainstay for evaluating possible metastasis and recurrence of ovarian cancer, it can be difficult in the diagnosis of calcified recurrent metastasis, which may be otherwise confused with old granulomatous disease or calcifications due to previous anticancer treatment.…”

Pseudomyxoma peritonei with progressive calcifications: CT findings

“…CT scans show them as tiny discrete calcifications peritoneal plaques in 40% of patients with peritoneal metastasis due to ovarian cancer [18]. Meconium peritonitis may also cause plaque-like or ring-like calcifications in the neonate [19].…”

Role of Imaging in Peritoneal Surface Malignancies

“…Differentiating the true PMP from mucinous carcinomatosis at CT alone is difficult because their CT findings overlap despite their different pathologic features and clinical course. [6] Mucinous carcinomatosis tends to involve the chest more frequently with effusions or pleural masses and may also be accompanied by mesenteric or retroperitoneal lymphadenopathy, omental caking, and invasion into parenchymal organs [39].…”