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{{Ovarian germ cell tumor}}
{{Ovarian germ cell tumor}}
{{CMG}}; {{AE}} {{MD}}
{{CMG}}; {{AE}} {{MD}} {{Sahar}}
==Overview==
==Overview==
 
It is difficult to distinguish [[ovarian]] [[germ cell]] [[tumors]] on [[CT]] alone, however, [[pelvic]]/[[abdominal]] CT scan may be helpful in the diagnosis. Sensitive findings on [[CT scan]] for the [[diagnosis]] of [[Mature cystic teratoma|mature teratoma]] include [[Fat]] attenuation, presence or absence of [[calcification]] in the [[cyst]] wall, palm-tree like protrusion, and [[fat]]-[[fluid]] levels. Presence of cauliflower appearance with irregular borders may warrant the necessity to search for [[malignant transformation]] of these [[tumors]]. [[CT scan]] findings characteristics of immature [[teratoma]] include A large, irregular [[solid]] [[mass]], presence of coarse [[calcification]], small foci of [[fat]], and [[Hemorrhage]]. CT findings associated with other [[ovarian]] [[germ cell]] [[tumors]] are not specific, but may be helpful.
There are no CT scan findings associated with [disease name].
 
OR
 
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
 
It is difficult to distinguish ovarian germ cell tumors on CT alone. [[Dysgerminoma]] often appears as multilobulated solid masses with prominent fibrovascular septa while mature ovarian teratoma may demonstrate fat (areas with very low Hounsfield values), fat-fluid level, calcification (sometimes dentiform), Rokitansky protuberance, and tufts of [[hair]].<ref name= xab> Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015</ref><ref name= abc> Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015</ref><ref name= yyy> Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015</ref>
 
==CT==
==CT==
 
===Mature teratoma===
There are no CT scan findings associated with [disease name].
[[CT scan]] is a sensitive method to [[diagnose]] [[Mature cystic teratoma|mature teratoma]]. Findings on [[Computed tomography|CT scan]] suggestive of/diagnostic of [[Mature cystic teratoma|mature teratoma]] include:<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>
 
*[[Fat]] attenuation
OR
*Presence or absence of [[calcification]] in the [[cyst]] wall
 
*Gravity dependent layering<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>
[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include:
*Palm-tree like protrusion
*[Finding 1]
*[[Fat]]-[[fluid]] levels
*[Finding 2]
* Whenever cauliflower appearance with irregular borders are observed, [[malignant transformation]] should be suspected.<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>
*[Finding 3]
===Immature teratoma===
 
[[CT scan]] findings of immature [[teratoma]] are characteristics and include:<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>
OR
* A large, irregular [[solid]] [[mass]]
 
* Presence of coarse [[calcification]]
There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include:
* Small foci of [[fat]]
*[Complication 1]
* [[Hemorrhage]] may also be present.
*[Complication 2]
===Dysgerminoma===
*[Complication 3]
[[CT scan]] findings of [[dysgerminoma]] include:
 
* [[Lobular|Lobulated]] pattern 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>
'''Dysgerminomas '''<ref name= xab> Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015</ref>
* Areas of [[septa]] which are enhnacing
* [[Calcification ]]may be present in a speckled pattern. Characteristic imaging findings include multilobulated solid masses with prominent fibrovascular septa
* Areas of [[hemorrhage]] and [[necrosis]] which appear [[cystic]]
* Post contrast imaging can often show enhancement of the septae
* Speckled pattern of [[calcification]]
 
===Yolk sac tumor===
'''Mature (cystic) ovarian teratoma'''<ref name= abc> Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015</ref>
[[CT scan]] findings of [[yolk sac tumor]] include:
* [[CT ]]has high sensitivity in the diagnosis of cystic [[teratoma]]s though it is not routinely recommended for this purpose owing to its ionizing radiation
* The bright dot [[Sign name|sign]] (enhancing foci in the wall or [[solid]] component) is the common finding, although it is not the pathognomonic finding for the [[yolk sac tumor]].<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>
* Typically CT images demonstrate fat (areas with very low Hounsfield values), fat-fluid level, calcification (sometimes dentiform), Rokitansky protuberance, and tufts of [[hair]]
* [[Capsule|Capsular]] tear is another common finding which is not the pathognomonic finding for the [[yolk sac tumor]].
* The presence of most of the above tissues is diagnostic of ovarian cystic teratomas in 98% of cases
* Whenever the size exceeds 10 cm or soft tissue plugs and cauliflower appearance with irregular borders are seen, [[malignant]] transformation should be suspected
* When ruptured, the characteristic hypoattenuating fatty fluid can be found as antidependent pockets, typically below the right hemidiaphragm, a pathognomonic finding 
* The escaped [[cyst]] content also leads to a chemical [[peritonitis ]]and the [[mesentery]] may be stranded and the [[peritoneum ]]thickened, which may mimic [[peritoneal]] carcinomatosis
 
'''Immature teratoma'''<ref name= yyy> Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015</ref>
* The presence of a prominent solid component containing calcifications and small foci of fat are suggestive
* Cystic components may contain [[serous]], [[mucinous]], or fatty sebaceous material, [[hemorrhage]] may be present
 
 
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 13:57, 22 April 2019

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

Overview

It is difficult to distinguish ovarian germ cell tumors on CT alone, however, pelvic/abdominal CT scan may be helpful in the diagnosis. Sensitive findings on CT scan for the diagnosis of mature teratoma include Fat attenuation, presence or absence of calcification in the cyst wall, palm-tree like protrusion, and fat-fluid levels. Presence of cauliflower appearance with irregular borders may warrant the necessity to search for malignant transformation of these tumors. CT scan findings characteristics of immature teratoma include A large, irregular solid mass, presence of coarse calcification, small foci of fat, and Hemorrhage. CT findings associated with other ovarian germ cell tumors are not specific, but may be helpful.

CT

Mature teratoma

CT scan is a sensitive method to diagnose mature teratoma. Findings on CT scan suggestive of/diagnostic of mature teratoma include:[1]

Immature teratoma

CT scan findings of immature teratoma are characteristics and include:[3]

Dysgerminoma

CT scan findings of dysgerminoma include:

Yolk sac tumor

CT scan findings of yolk sac tumor include:

  • The bright dot sign (enhancing foci in the wall or solid component) is the common finding, although it is not the pathognomonic finding for the yolk sac tumor.[4]
  • Capsular tear is another common finding which is not the pathognomonic finding for the yolk sac tumor.

References

  1. ↑ 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.
  2. ↑ 2.0 2.1 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.
  3. ↑ 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.

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