Ovarian germ cell tumor CT
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Ovarian germ cell tumor Microchapters |
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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]
Dysgerminomas
- 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
- 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 mimicperitoneal carcinomatosis
Immature teratoma
CT and MRI
- The presence of a prominent solid component containing calcifications and small foci of fat is suggestive
- Cystic components may contain serous, mucinous, or fatty sebaceous material. Haemorrhage may be present
Ovarian choriocarcinoma
On imaging, choriocarcinomas appear as vascular solid tumours with cystic, haemorrhagic, and necrotic areas.