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: Sahar Memar Montazerin, M.D.[2] Monalisa Dmello, M.B,B.S., M.D. [3]

Overview

It is difficult to distinguish ovarian germ cell tumors on ultrasound alone. Both solid and cystic lesions with calcification may be present. Dysgerminoma often appears as a hypoechoic mass while other ovarian germ cell tumors often have variable echogenicity. Ovarian teratoma may be further characterized by the presence of sebaceous and hair components arising from the Rokitansky protuberance.

Ovarian mature teratoma

Ultrasound is the most frequently used modality for the diagnosis.^[1]
On Ultrasound imaging, it may have variable appearances, however, the three most common appearances from the most common to least common include:^[1]^[2]
- Cystic lesion with a projecting tubercle (Rokitansky nodule) into the cyst lumen that is densely echogenic
- A mass with partial or diffuse echogenicity due to sebaceous material and hair within the cyst cavity
- A cyst cavity with multiple thin, echogenic bands owing to hair materials

Immature ovarian teratoma

Ultrasound imaging is not helpful for the diagnosis of immature teratoma.^[3]
The US finding are usually nonspecific and include:
- Heterogeneous appearance with partially solid lesion
- Foci of calcification

Monodermal teratoma

Struma ovarii:
- Nonspecific finding on the ultrasound imaging.^[3]
- A heterogeneous mass which is predominantly solid
- A complex mass with multiple solid and cystic areas

Dysgerminoma

They are purely solid (with rare exceptions)^[4]
Lobulated components with heterogeneous echogenicity and with well-defined borders.

On color and power Doppler ultrasound:

Yolk sac tumor

Embryonal carcinoma

↑ ^1.0 ^1.1 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.
↑ 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.
↑ ^3.0 ^3.1 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.
↑ ^4.0 ^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.