Ovarian germ cell tumor CT

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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]

Overview

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.

CT

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]
• [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]
• [Complication 3]

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 ionizing 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

• 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