Ovarian germ cell tumor ultrasound

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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]

Ultrasound dysgerminomas May be seen as a septated ovarian mass with varying echotexture. Colour Doppler interrogation may show prominent flow signal within the fibrovascular septa 2.

ovarian dermoid Pelvic ultrasound

• 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.
• The spectrum of sonographic features includes:
• diffusely or partially echogenic mass with posterior sound attenuation owing to sebaceous material and hair within the cyst cavity
• echogenic interface at the edge of mass that obscures deep structures: the tip of the iceberg sign
• mural hyperechoic Rokitansky nodule: dermoid plug
• echogenic, shadowing calcific or dental (tooth) components
• presence of fluid-fluid levels 5
• multiple thin, echogenic bands caused by hair in the cyst cavity: the dot-dash pattern
• colour Doppler: no internal vascularity
• internal vascularity requires further workup to exclude a malignant lesion

Immature ovarian teratoma Ultrasound appearance can be as a heterogeneous adnexal mass although is non-specific. Calcifications may be present.

Ovarian yolk sac tumour

• The tumour typically manifests as a large, complex pelvic mass that extends into the abdomen and contains both solid and cystic components.
• 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.