MRI spectrum of clear cell carcinoma of the ovary

Congress:

ECR 2018

Poster Number:

C-2900

Type:

Educational Exhibit

Keywords:

Pathology, Diagnostic procedure, MR, Genital / Reproductive system female

Authors:

E. Yamashita, U. Sakurai, Y. Himeno; Tokyo/JP

DOI:

10.1594/ecr2018/C-2900

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2900

Fig. 1: The WHO classification of ovarian epithelial carcinoma 2014

Fig. 2: General features of clear cell carcinoma

Fig. 3: How to detect malignant ovarian tumors from benign tumors on MRI

Fig. 4: MRI features of clear cell carcinoma

Learning objectives

To be familiar with the appearance of clear cell carcinoma of the ovary on MRI focused on the combination of various signal intensities on T2WI, DWI, ADC values and enhanced pattern on dynamic contrast-enhanced MRI.

Background

According to the WHO classification 2014, ovarian epithelial carcinoma is classified into seven types of serous carcinoma, mucinous carcinoma, endometrioid carcinoma, clear cell carcinoma, malignant Brenner tumor, seromucinous carcinoma and undifferentiated carcinoma (Fig.1) [1]. Clear cell carcinoma (CCC) of the ovary accounts for 5-10% of surface epithelial carcinoma but for 20% in Japan and is known as the most frequently associated with ovarian and pelvic endometriosis in 50-70% of cases. As the background of endometriosis, the mean age is 55years in contrast to 63 years...

Findings and procedure details

We present the appearance of MR imaging of 20 patients with CCCs performed MRI with 1.5T unit and confirmed pathologically by surgery in our hospital from 2013 to 2017. DWI was obtained on b=0, b=800 before June 2016 and was obtained on b=0,1000 after June 2016. In addition to the pathological diagnosis, we evaluated six factors of CCCs in order to compare with the previous studies as follows; a) age b) FIGO stage c) CA125 value d) maximum tumor size e) protrusions within the tumor...

Conclusion

IIn our series, it was revealed that CCCs had possiblities to demonstrate various pattern SI and enhancement due to hemorrhage, necrosis and inflammation within the solid component and distribution of fibrous stroma. Knowing the characteristics of various combination with morphology, signal intensities, enhanced pattern of CCCs can be helpful to diagnose it preoperatively for both of radiologists and gynecologists

Personal information

References

[1]　World Health Organization: Tumours of the ovary, Kurman RJ ed: WHO Classification of Tumours of Female Reproductive Organs.p11-86, IARC, Lyon, 2014 [2] Clement PB YR. Surface epithelial-stromal tumors; general features, serous tumors, and mucinous tumors, endometrioid, clear cell, transitional, squamous, rare, undifferentiated, and mixed cell types. Atlas of Gynecologic Surgical Pathology 3rd ed. London: Elsevier, 2014: p343-407. [3] Seidman JD et al. Surface Epithelial Tumors of the Ovary. Kurman RJ ed. Blaunstein's Pathology of the Female Genital Tract 6th ed. ed. New York: Springer,...