Learning objectives
1.
to enumerate the most common types of ovarian teratomas;
2.
to highlight the main semiological elements that support the diagnosis,
evaluated by ultrasonography,
computer tomography (CT) and magnestic resonance (MR)
3.
to illustrate the semiological elements revising through some cases of mature cystic ovarian teratoma
Background
•the most common ovarian neoplasms in young patients (mean age 20-30 years old);
•germinal cell tumors derived from ectopic multipotential cells,
whose migration from the yolk sac endoderm to the urogenital crest during embryogenesis does not occur;
•benign,
well-differentiated cystic lesions/ solid and malignant;
•ovarian teratomas:
•mature cystic teratomas(sebaceous material,
calcifications,
fat)
•immature teratomas (a nonspecific appearance,
being heterogeneous,
with irregular solid component and scattered calcifications)
•monodermal teratomas
Mature cystic teratoma
•the most common ovarian neoplasm
•ectodermal tissue (skin derivatives and neural tissue),
mesodermal tissue...
Findings and procedure details
We analyzed retrospectively a total of 30 cases evaluated by ultrasonography,
computer tomography (CT) and magnetic resonance (MR),
highlighting the main semiological elements that support the diagnosis.
Ultrasound findings (fig.
1-7)
•the imaging modality for initial diagnose
•cystic lesion with a mural hyperechogenic nodule called Rokitansky nodule with acoustic shadow; Rokitansky nodule (dermoid plug) = hair and/or sebaceous components (plump of hair that absorbes and reflects sound at US)
• the tip of the iceberg sign (diffusely or partially echogenic mass with posterior sound attenuation;...
Conclusion
The radiographic image of teratoma,
from identification of the adipose component by CT or MR,
to the cystic component with/ without mural thickening by ultrasonography or MR,
corroborated with the early detection of this pathology are essential for establishing a correct diagnosis and planning the treatment,
avoiding the possible complications.
References
1.Outwater,
E.
K.,
Siegelman,
E.
S.,
& Hunt,
J.
L.
(2001).
Ovarian teratomas: tumor types and imaging characteristics.
Radiographics : A Review Publication of the Radiological Society of North America,
Inc,
21(2),
475–490.
2.Saba,
L.,
Guerriero,
S.,
Sulcis,
R.,
Virgilio,
B.,
Melis,
G.
B.,
& Mallarini,
G.
(2009).
Mature and immature ovarian teratomas: CT,
US and MR imaging characteristics.
European Journal of Radiology.
3.Rha,
S.
E.,
Byun,
J.
Y.,
Jung,
S.
E.,
Kim,
H.
L.,
Oh,
S.
N.,
Kim,
H.,
… Lee,
J.
M.
(2004)....