Ovarian germ cell tumor CT: Difference between revisions
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==Overview== | ==Overview== | ||
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> | 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== | ||
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* Whenever the size exceeds 10 cm or soft tissue plugs and cauliflower appearance with irregular borders are seen, [[malignant]] transformation should be suspected | * 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 | * 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 | * 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> | '''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 | * 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 | * Cystic components may contain [[serous]], [[mucinous]], or fatty sebaceous material, [[haemorrhage]] may be present | ||
Revision as of 16:55, 19 November 2015
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Ovarian germ cell tumor Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ovarian germ cell tumor CT On the Web |
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American Roentgen Ray Society Images of Ovarian germ cell tumor CT |
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Risk calculators and risk factors for Ovarian germ cell tumor CT |
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]
Overview
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.[1][2][3]
CT
Dysgerminomas [1]
- Calcification may be present in a speckled pattern. Characteristic imaging findings include multilobulated solid masses with prominent fibrovascular septa
- Post contrast imaging can often show enhancement of the septae
Mature (cystic) ovarian teratoma[2]
- CT has high sensitivity in the diagnosis of cystic teratomas though it is not routinely recommended for this purpose owing to its ionising radiation
- Typically CT images demonstrate fat (areas with very low Hounsfield values), fat-fluid level, calcification (sometimes dentiform), Rokitansky protuberance, and tufts of hair
- 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[3]
- 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, haemorrhage may be present
References
- ↑ 1.0 1.1 Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015
- ↑ 2.0 2.1 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015
- ↑ 3.0 3.1 Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015