Ovarian tumors - spectrum of findings
Number:27ESURABS0073
Type:Educational Electronic Presentation
Authors: José Eduardo Rosa, Sara Peixoto, Sónia Palma, Manuel Abecasis
Keywords:Ovarian Cysts; Ovarian Neoplasms; Computer Tomography; Magnetic Resonance.
SECTIONS
Educational objective

To review and discuss clinical cases regarding different types of ovarian tumours.

To illustrate the radiological features of these different tumours, using computer tomography and magnetic resonance images.

Fig. 1 - MRI images: T1- weighted axial images (a); T2 - TSE weighted axial images (b); T1- weighted after contrast images (c) showing a mass with heterogeneous sign intensity in the right ovary, with some loculi with low sign in T1-weighted images and high sign in T2-weighted images. They show enhancing portions. This lesion was a mucinous adenocarcinoma.

Topic Review

Ovarian tumours are one of the most common primary tumours in women and are the most lethal among gynaecological cancers.

Physiological ovarian cysts are the vast majority of cystic adnexal lesions. Cysts can be classified as functional, associated with hormone production, or non-functional.

Primary ovarian tumours are divided into three major categories: epithelial tumours, germ cell tumours (GCTs) and sex cord-stromal tumours.

Epithelial tumours are the most common, accounting for about 60% of all ovarian tumours and 90% of malignant ovarian tumours.

Epithelial tumours are further divided into seven subtypes: serous, mucinous, endometrioid, clear cell, Brenner, seromucinous and undifferentiated.

The first six types can be further subdivided into benign, borderline and malignant tumours.

Malignant epithelial tumours include by order of...

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Fig. 2 - MRI images: T2-TSE weighted axial images (a); T1- weighted after contrast sagital images (b); T2 - sagital images (c) showing a cystic lesion with solid component (red arrow) that enhances. This lesion was a serous adenocarcinoma.


Conclusions

Given the frequent contact of the radiologist with ovarian tumours, the knowledge of the radiological features of these tumours is of crucial importance. There are some imaging features that are suggestive of malignancy: size larger than 4 cm; thickness of wall or septa; papillary projections; necrosis; the presence of ascites; cystic and solid internal architecture; a lobulated solid mass; and presence of tumour vessels. Radiologists must know the signs that suggest a benign or malignant aetiology. Proper and timely diagnosis of these can improve the staging accuracy and allow better management and outcome of the disease.

Fig. 3 - MRI images: T1-TSE weighted axial images (a); T1- weighted after contrast sagital images (b); T2 - TSE axial images (c) showing a cystic lesion with some loculi (red arrow) with low sign in T1-weighted images and high sign in T2-weighted images lesion with no significant enhancement. This lesion was a mucinous cistadenoma.