Title: Ovarian cancer arising in endometrioid cysts: ultrasound findings
Authors: Testa, Ac ×
Timmerman, Dirk
Van Holsbeke, Caroline
Zannoni, Gf
Fransis, S
Moerman, Philippe
Vellone, V
Mascilini, F
Licameli, A
Ludovisi, M
Di Legge, A
Scambia, G
Ferrandina, G #
Issue Date: Feb-2011
Publisher: Blackwell Science
Series Title: Ultrasound in Obstetrics & Gynecology vol:38 pages:99-106
Article number: 10.1002/uog.8970
Abstract: OBJECTIVES: To describe sonographic characteristics of malignant transformation in endometrioid cysts. METHODS: Women with histological diagnosis of ovarian endometrioid cysts, borderline tumors, and carcinoma arising in endometrioid cysts, preoperatively examined at ultrasound examination, were included in the retrospective study. The gray-scale and Doppler ultrasound characteristics of the endometrioid cysts were compared with those of borderline and primary cancer developed in endometrioid cysts. The performance of an experienced examiner in classifying the masses was also assessed. RESULTS: Of 324 cases collected for the study, 309 (95.3%) lesions were classified as endometrioid cysts, 4 (1.2%) as borderline tumors and 11 (3.4%) as carcinoma arising in endometrioid cysts. Cases with malignant findings (BOT and cancers) were older than those with benign endometrioid cysts (median 52 years, range 28-79 versus 34, range 18-76; p < 0.0001), and the prevalence of postmenopausal status was significantly higher in malignant cases. All malignant tumors (15/15) versus 16% (50/309) of benign tumors were characterized by the presence of solid tissue (p<.0001). The prevalence of solid tissue with positive Doppler signals was higher in malignant tumors (100%) than in benign cyst (12%) (p<.0001). Papillary projections represented a more frequent sonographic feature among malignant lesions (86.7%) than among benign endometrioid cysts (11.3%) (p<.0001); power Doppler signals were detected within the projections in 92.3% and in 37.1% of malignant and benign lesions, respectively. The examiner correctly diagnosed as benign 94.8% (293/309) of benign lesions and as malignant 93.3% (14/15) of malignant lesions. The risk estimation of the examiner was "uncertain" in 3 (20%) and "probably/certainly malignant" in 12 (80%) of 15 malignant cases. CONCLUSIONS: Borderline tumors and carcinomas arising in endometrioid cysts show a vascularised solid component at ultrasound examination, and this figure was present in all malignant transformation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
ISSN: 0960-7692
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Gynaecological Imaging Section (-)
Interdepartmental Platform Hospital Care
Translational Cell & Tissue Research
× corresponding author
# (joint) last author

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