CASE 172 Published on 21.05.2000
0

Ovarian cancer

Section

Genital (female) imaging

Case Type

Clinical Cases

Authors

Bassetti E,Sarrantonio A, Catalano C, Panebianco V

Connected authors
Patient

44 years, female

Categories
No Area of Interest ; Imaging Technique Ultrasound, CT
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Clinical History
Acute abdominal pain, pelvic palpable mass
Imaging Findings
Patient was admitted to our hospital because of acute abdominal pain localized in the inferior abdominal quadrants where it was possible to appreciate a mass of ligneous consistence. Body temperature was 36.8ยก Laboratory findings were normal.
Discussion
US and CT findings (pelvic mass with mixed parenchimal structure, presence of internal and irregular septa, marked enhancement of septa and solid portion), suggest hypotesis of ovarian cystoadenocarcinoma. Among the gynecologic malignancies, ovarian cancer is the second most common in incidence (1). As most patients presents with advanced disease, the prognosis is poor. Five year survival is only 41% for all stages (2). Both MR and CT can be helpful adjunct in the treatment planning of ovarian cancer. Several studies have addressed the value of CT in the preoperative management of ovarian tumor with reported accuracies of 77%; staging accuracy for MR imaging was similar 78% (3). Detection of peritoneal implants on CT and MR has been studied extensively and both modalities had limitation in detection of implant lesion smaller than 10 mm and localized on bowel surface, mesentery and peritoneum (3). MR now seems to be superior to in the evaluation of local extention of the tumor and in the definition of implants with possible involvment of the hemidiaphragma and liver surface. However cross sectional imaging provides paramount information for surgical and management planning
Differential Diagnosis List
Ovarian papilliferous cystadenocarcinoma
Final Diagnosis
Ovarian papilliferous cystadenocarcinoma
Case information
URL: https://eurorad.org/case/172
DOI: 10.1594/EURORAD/CASE.172
ISSN: 1563-4086
Figure 1

Ultrasound examination

Ultrasound examination
US images obtained in axial and sagital planes demonstres a mass with mixed solid-liquid parenchimal ecotexture with internal and irregular septa. Mass is localized in the pelvis anteriorly to the uterus. Color-doppler US demonstres also that the solid component had an hypervascular nature.
Ultrasound examination
US images obtained in axial and sagital planes demonstres a mass with mixed solid-liquid parenchimal ecotexture with internal and irregular septa. Mass is localized in the pelvis anteriorly to the uterus. Color-doppler US demonstres also that the solid component had an hypervascular nature.
Ultrasound examination
US images obtained in axial and sagital planes demonstres a mass with mixed solid-liquid parenchimal ecotexture with internal and irregular septa. Mass is localized in the pelvis anteriorly to the uterus. Color-doppler US demonstres also that the solid component had an hypervascular nature.
Figure 2

CT ehnanced images obtained in spiral acquisition

CT ehnanced images obtained in spiral acquisition
CT ehnanced images obtained in spiral acquisition on axial plane confirm the above data and showed a mass measuring 8X10X16cm anteriorly to the uterus. The lesion has a solid and a cystic component, the latter being pluriconcamerated with thin and irregular septa. The enhancement of the solid portion and internal septa is marked.
CT ehnanced images obtained in spiral acquisition
CT ehnanced images obtained in spiral acquisition on axial plane confirm the above data and showed a mass measuring 8X10X16cm anteriorly to the uterus. The lesion has a solid and a cystic component, the latter being pluriconcamerated with thin and irregular septa. The enhancement of the solid portion and internal septa is marked.
CT ehnanced images obtained in spiral acquisition
CT ehnanced images obtained in spiral acquisition on axial plane confirm the above data and showed a mass measuring 8X10X16cm anteriorly to the uterus. The lesion has a solid and a cystic component, the latter being pluriconcamerated with thin and irregular septa. The enhancement of the solid portion and internal septa is marked.
CT ehnanced images obtained in spiral acquisition
CT ehnanced images obtained in spiral acquisition on axial plane confirm the above data and showed a mass measuring 8X10X16cm anteriorly to the uterus. The lesion has a solid and a cystic component, the latter being pluriconcamerated with thin and irregular septa. The enhancement of the solid portion and internal septa is marked.
Figure 3

Histology

Histology
It is possible to appreciate small papillae with pseudoglandulae lined by columnar epithelium composed by cells characterized by large nucleoli