Ovarian germ cell tumor ultrasound: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(33 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Ovarian germ cell tumor}}
{{Ovarian germ cell tumor}}
 
{{CMG}}{{AE}} {{Sahar}} {{MD}}
{{CMG}}{{AE}} {{MD}}
==Overview==
 
It is difficult to distinguish [[ovarian]] [[germ cell]] [[tumors]] on [[ultrasound]] alone. Both [[solid]] and [[cystic]] [[lesions]] with [[calcification]] may be present. Dysgerminoma often appears as a [[Echogenicity|hypoechoic]] [[mass]] while other [[ovarian]] [[germ cell]] [[tumors]] often have variable [[echogenicity]]. Ovarian teratoma may be further characterized by the presence of [[sebaceous]] and [[hair]] components arising from the Rokitansky protuberance.
Ultrasound
==Ultrasound==
dysgerminomas
'''Ovarian mature teratoma'''
May be seen as a septated ovarian mass with varying echotexture. Colour Doppler interrogation may show prominent flow signal within the fibrovascular septa 2.
*[[Ultrasound]] is the most frequently used [[modality]] for the [[diagnosis]].<ref name="SabaGuerriero2009">{{cite journal|last1=Saba|first1=Luca|last2=Guerriero|first2=Stefano|last3=Sulcis|first3=Rosa|last4=Virgilio|first4=Bruna|last5=Melis|first5=GianBenedetto|last6=Mallarini|first6=Giorgio|title=Mature and immature ovarian teratomas: CT, US and MR imaging characteristics|journal=European Journal of Radiology|volume=72|issue=3|year=2009|pages=454–463|issn=0720048X|doi=10.1016/j.ejrad.2008.07.044}}</ref>
 
*On [[Ultrasound]] imaging, it may have [[Variable-order Markov model|variable]] appearances, however, the three most common appearances from the most common to least common include:<ref name="SabaGuerriero2009">{{cite journal|last1=Saba|first1=Luca|last2=Guerriero|first2=Stefano|last3=Sulcis|first3=Rosa|last4=Virgilio|first4=Bruna|last5=Melis|first5=GianBenedetto|last6=Mallarini|first6=Giorgio|title=Mature and immature ovarian teratomas: CT, US and MR imaging characteristics|journal=European Journal of Radiology|volume=72|issue=3|year=2009|pages=454–463|issn=0720048X|doi=10.1016/j.ejrad.2008.07.044}}</ref><ref name="pmid11259710">{{cite journal |vauthors=Outwater EK, Siegelman ES, Hunt JL |title=Ovarian teratomas: tumor types and imaging characteristics |journal=Radiographics |volume=21 |issue=2 |pages=475–90 |date=2001 |pmid=11259710 |doi=10.1148/radiographics.21.2.g01mr09475 |url=}}</ref>
 
**[[Cystic]] [[lesion]] with a projecting [[Tubercle (anatomy)|tubercle]] (Rokitansky [[nodule]]) into the [[cyst]] [[lumen]] that is [[Dens|densely]] [[echogenic]]
Conventional radiography
**A mass with partial or diffuse echogenicity due to [[sebaceous]] material and [[ hair]] within the [[cyst]] [[cavity]]
 
**A [[cyst]] [[cavity]] with multiple thin, [[echogenic]] [[bands]] owing to [[hair]] materials
Mature (cystic) ovarian teratomaMay show calcific and tooth components with the pelvis.
'''Immature ovarian teratoma'''
 
* [[Ultrasound imaging]] is not helpful for the [[diagnosis]] of immature teratoma.<ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref>
Pelvic ultrasound
* The [[Ultrasound|US]] finding are usually nonspecific and include:
* Ultrasound is the preferred imaging modality. Typically an ovarian dermoid is seen as a cystic adnexal mass with some mural components. Most lesions are unilocular.
** [[Heterogeneous]] appearance with partially [[solid]] [[lesion]]
* The spectrum of sonographic features includes:
** Foci of [[calcification]]
* diffusely or partially echogenic mass with posterior sound attenuation owing to sebaceous material and hair within the cyst cavity
'''Monodermal teratoma'''
* echogenic interface at the edge of mass that obscures deep structures: the tip of the iceberg sign
* Struma ovarii:
* mural hyperechoic Rokitansky nodule: dermoid plug
** Nonspecific finding on the [[ultrasound imaging]].<ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref>
* echogenic, shadowing calcific or dental (tooth) components
** A [[heterogeneous]] [[mass]] which is predominantly [[solid]]
* presence of fluid-fluid levels 5
** A complex [[mass]] with multiple [[solid]] and [[cystic]] areas
* multiple thin, echogenic bands caused by hair in the cyst cavity: the dot-dash pattern
'''Dysgerminoma'''
* colour Doppler: no internal vascularity
* They are purely [[solid]] (with rare exceptions)<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref>
* internal vascularity requires further workup to exclude a malignant lesion
* [[Lobular|Lobulated]] components with [[heterogeneous]] [[echogenicity]] and with well-defined borders.
 
On color and power [[Doppler ultrasound]]:
 
* These [[Tumor|tumors]] are highly [[Vascular|vascularized]].
Immature ovarian teratoma
'''Yolk sac tumor'''
Ultrasound appearance can be as a heterogeneous adnexal mass although is non-specific. Calcifications may be present.
* [[Heterogeneous]] [[echogenicity]] in the [[solid]] portion<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref>
 
* [[Septa|Septas]] dividing the [[cystic]] portion
Ovarian yolk sac tumour
'''Embryonal carcinoma'''
* The tumour typically manifests as a large, complex pelvic mass that extends into the abdomen and contains both solid and cystic components.  
* There is no specific [[imaging]] criteria for embryonal carcinoma.
* The cystic areas are composed of epithelial lined cysts produced by the tumour or of co-existing mature teratomas.  
* Bilaterality is rare.
* Tends to have both echogenic and hypoechoic components.
 
Ovarian choriocarcinoma
On imaging, choriocarcinomas appear as vascular solid tumours with cystic, haemorrhagic, and necrotic areas.
 


==References==
==References==

Latest revision as of 13:56, 22 April 2019

Ovarian germ cell tumor Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Ovarian germ cell tumor from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Staging

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Surgery

Chemotherapy

Radiotherapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ovarian germ cell tumor ultrasound On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ovarian germ cell tumor ultrasound

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ovarian germ cell tumor ultrasound

CDC on Ovarian germ cell tumor ultrasound

Ovarian germ cell tumor ultrasound in the news

Blogs on Ovarian germ cell tumor ultrasound

Directions to Hospitals Treating Ovarian germ cell tumor

Risk calculators and risk factors for Ovarian germ cell tumor ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Monalisa Dmello, M.B,B.S., M.D. [3]

Overview

It is difficult to distinguish ovarian germ cell tumors on ultrasound alone. Both solid and cystic lesions with calcification may be present. Dysgerminoma often appears as a hypoechoic mass while other ovarian germ cell tumors often have variable echogenicity. Ovarian teratoma may be further characterized by the presence of sebaceous and hair components arising from the Rokitansky protuberance.

Ultrasound

Ovarian mature teratoma

Immature ovarian teratoma

Monodermal teratoma

Dysgerminoma

On color and power Doppler ultrasound:

Yolk sac tumor

Embryonal carcinoma

  • There is no specific imaging criteria for embryonal carcinoma.

References

  1. ↑ 1.0 1.1 Saba, Luca; Guerriero, Stefano; Sulcis, Rosa; Virgilio, Bruna; Melis, GianBenedetto; Mallarini, Giorgio (2009). "Mature and immature ovarian teratomas: CT, US and MR imaging characteristics". European Journal of Radiology. 72 (3): 454–463. doi:10.1016/j.ejrad.2008.07.044. ISSN 0720-048X.
  2. ↑ Outwater EK, Siegelman ES, Hunt JL (2001). "Ovarian teratomas: tumor types and imaging characteristics". Radiographics. 21 (2): 475–90. doi:10.1148/radiographics.21.2.g01mr09475. PMID 11259710.
  3. ↑ 3.0 3.1 Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
  4. ↑ 4.0 4.1 Shaaban, Akram M.; Rezvani, Maryam; Elsayes, Khaled M.; Baskin, Henry; Mourad, Amr; Foster, Bryan R.; Jarboe, Elke A.; Menias, Christine O. (2014). "Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features". RadioGraphics. 34 (3): 777–801. doi:10.1148/rg.343130067. ISSN 0271-5333.

Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Ovarian_germ_cell_tumor_ultrasound&oldid=1564380"