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.[1][2][3]

CT

Mature teratoma

CT scan is a sensitive method to daignose mature teratoma. Findings on CT scan suggestive of/diagnostic of mature teratoma include:[4]

  • Fat attenuation
  • Presence or absence of calcification in the cyst wall
  • Gravity dependent layering[5]
  • Palm-tree like protrusion
  • Fat-fluide levels
  • Whenever cauliflower appearance with irregular borders are observed, malignant transformation should be suspected.[5]

Immature teratoma

CT scan findings of immature teratoma are characteristics and include:[6]

  • A large, irregular solid mass
  • Presence of coarse calcification
  • Small foci of fat
  • Hemorrhage may also be present.

Dysgerminoma

  • Lobulated pattern in the solid portion[7]
  • Areas of septa which are enhnacing
  • Areas of hemorrhage and necrosis which appear cystic
  • Speckled pattern of calcification

Yolk sac tumor

  • The bright dot sign (enhancing foci in the wall or solid component) is the common finding, although it is not the pathognomonic finding for the yolk sac tumor.[7]
  • Capsular tear is another common finding which is not the pathognomonic finding for the yolk sac tumor.

References

  1. Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015
  2. Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015
  3. Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015
  4. 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.
  5. 5.0 5.1 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.
  6. 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.
  7. 7.0 7.1 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.

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