Imaging in gynecological disease (29) : clinical and ultrasound features of primary ovarian immature teratoma

Landolfo, C.; Froyman, W.; Testa, A. C.; Fischerova, D.; Franchi, D.; Yazbek, J.; Saso, S.; Fruscio, R.; Chiappa, V.; Czekierdowski, A.; Van Gorp, T.; Moro, F.; Savelli, L.; Zannoni, G. F.; Bourne, T.; Timmerman, D.; Valentin, L.; Guerriero, S.; Coosemans, A.; Van Holsbeke, C.; Sayasneh, A.; Helmy-Bader, S.; De Meis, L.; Del Forno, S.; Heremans, R.; Pascual, M. Angela; Piras, A.; Hovsepyan, L.; Hiett, A. K.; Verbakel, J. Y.; Van Nieuwenhuysen, E.; Seckl, M.; Vergote, I.

Imaging in gynecological disease (29) : clinical and ultrasound features of primary ovarian immature teratoma

Mark

Landolfo, C. ; Froyman, W. ; Testa, A. C. ; Fischerova, D. ; Franchi, D. ; Yazbek, J. ; Saso, S. ; Fruscio, R. ; Chiappa, V. and Czekierdowski, A. , et al. (2025) In Ultrasound in Obstetrics and Gynecology

Abstract: Objective: To describe the clinical and ultrasound characteristics at the time of diagnosis of primary ovarian immature teratoma with no other germ cell tumor components described on histopathology. Methods: This was a retrospective study of women with a histological diagnosis of primary ovarian immature teratoma who had undergone a preoperative ultrasound examination between 1998 and 2024. Cases were identified from the databases of 17 contributing ultrasound centers and the International Ovarian Tumor Analysis (IOTA) database. The descriptions of the ultrasound images of the tumors made by the original ultrasound examiners using IOTA terminology were reported. In addition, grayscale and color or power Doppler ultrasound images or... (More); Objective: To describe the clinical and ultrasound characteristics at the time of diagnosis of primary ovarian immature teratoma with no other germ cell tumor components described on histopathology. Methods: This was a retrospective study of women with a histological diagnosis of primary ovarian immature teratoma who had undergone a preoperative ultrasound examination between 1998 and 2024. Cases were identified from the databases of 17 contributing ultrasound centers and the International Ovarian Tumor Analysis (IOTA) database. The descriptions of the ultrasound images of the tumors made by the original ultrasound examiners using IOTA terminology were reported. In addition, grayscale and color or power Doppler ultrasound images or videoclips were retrieved for all tumors. Two independent ultrasound examiners reviewed the retrieved material and searched for specific ultrasound characteristics of immature teratomas using pattern recognition. We present their agreed description of the tumors. Results: In total, 64 patients with ovarian immature teratoma were included, of which 38 (59.4%) were obtained from the IOTA database (IOTA studies phase 1, 1b, 2, 3, 5 and 7). The median age of the patients at diagnosis was 24.5 (interquartile range (IQR), 18.8–31.0; range, 12–50) years. The most common presenting symptoms were abdominal or pelvic pain (38/60, 63.3%) and abdominal swelling (30/60, 50.0%). All immature teratomas were unilateral. The median largest diameter of the tumor was 149.5 (IQR, 125.0–183.8; range, 27–400) mm. Using IOTA terminology, most tumors were described as multilocular-solid (32/64, 50.0%) or solid lesions (22/64, 34.4%). When present, the solid component had a median largest diameter of 98.5 (IQR, 59.8–146.8; range 6–400) mm. Most masses showed minimal (19/63, 30.2%) or moderate (35/63, 55.6%) vascularization on color or power Doppler ultrasound examination. Using pattern recognition, the most typical ultrasound feature was heterogeneous, bizarre echogenicity of the solid components, with hyperechogenic areas, cystic spaces and acoustic shadows. This feature, which we consider pathognomonic, was present in 48/57 (84.2%) immature teratomas in which the solid components were adequately assessable. Conclusions: The typical ultrasound appearance of an ovarian immature teratoma is a large unilateral adnexal mass with large solid components that is poorly or moderately vascularized. The pathognomonic feature is heterogeneous echogenicity of the solid components with hyperechogenic areas, cystic spaces and acoustic shadows. Preoperative suspicion of immature teratoma can guide treatment, such as offering fertility-sparing surgery.
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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/54cd992f-5a6e-4523-a6bd-cf4d4123ba8c

author

Landolfo, C. ; Froyman, W. ; Testa, A. C. ; Fischerova, D. ; Franchi, D. ; Yazbek, J. ; Saso, S. ; Fruscio, R. ; Chiappa, V. and Czekierdowski, A. , et al. (More)

Landolfo, C. ; Froyman, W. ; Testa, A. C. ; Fischerova, D. ; Franchi, D. ; Yazbek, J. ; Saso, S. ; Fruscio, R. ; Chiappa, V. ; Czekierdowski, A. ; Van Gorp, T. ; Moro, F. ; Savelli, L. ; Zannoni, G. F. ; Bourne, T. ; Timmerman, D. ; Valentin, L. ^LU

; Guerriero, S. ; Coosemans, A. ; Van Holsbeke, C. ; Sayasneh, A. ; Helmy-Bader, S. ; De Meis, L. ; Del Forno, S. ; Heremans, R. ; Pascual, M. Angela ; Piras, A. ; Hovsepyan, L. ; Hiett, A. K. ; Verbakel, J. Y. ; Van Nieuwenhuysen, E. ; Seckl, M. and Vergote, I. (Less)

author collaboration

Collaborators

organization

Obstetric, Gynaecological and Prenatal Ultrasound Research (research group)

publishing date

2025

type

Contribution to journal

publication status

epub

subject

keywords

ovarian immature teratoma, ovarian neoplasm, ultrasonography

in

Ultrasound in Obstetrics and Gynecology

publisher

John Wiley & Sons Inc.

external identifiers

pmid:41118662
scopus:105021311725

ISSN

0960-7692

DOI

10.1002/uog.70111

language

English

LU publication?

yes

additional info

id

54cd992f-5a6e-4523-a6bd-cf4d4123ba8c

date added to LUP

2025-12-19 14:38:22

date last changed

2025-12-20 03:00:09

@article{54cd992f-5a6e-4523-a6bd-cf4d4123ba8c,
  abstract     = {{<p>Objective: To describe the clinical and ultrasound characteristics at the time of diagnosis of primary ovarian immature teratoma with no other germ cell tumor components described on histopathology. Methods: This was a retrospective study of women with a histological diagnosis of primary ovarian immature teratoma who had undergone a preoperative ultrasound examination between 1998 and 2024. Cases were identified from the databases of 17 contributing ultrasound centers and the International Ovarian Tumor Analysis (IOTA) database. The descriptions of the ultrasound images of the tumors made by the original ultrasound examiners using IOTA terminology were reported. In addition, grayscale and color or power Doppler ultrasound images or videoclips were retrieved for all tumors. Two independent ultrasound examiners reviewed the retrieved material and searched for specific ultrasound characteristics of immature teratomas using pattern recognition. We present their agreed description of the tumors. Results: In total, 64 patients with ovarian immature teratoma were included, of which 38 (59.4%) were obtained from the IOTA database (IOTA studies phase 1, 1b, 2, 3, 5 and 7). The median age of the patients at diagnosis was 24.5 (interquartile range (IQR), 18.8–31.0; range, 12–50) years. The most common presenting symptoms were abdominal or pelvic pain (38/60, 63.3%) and abdominal swelling (30/60, 50.0%). All immature teratomas were unilateral. The median largest diameter of the tumor was 149.5 (IQR, 125.0–183.8; range, 27–400) mm. Using IOTA terminology, most tumors were described as multilocular-solid (32/64, 50.0%) or solid lesions (22/64, 34.4%). When present, the solid component had a median largest diameter of 98.5 (IQR, 59.8–146.8; range 6–400) mm. Most masses showed minimal (19/63, 30.2%) or moderate (35/63, 55.6%) vascularization on color or power Doppler ultrasound examination. Using pattern recognition, the most typical ultrasound feature was heterogeneous, bizarre echogenicity of the solid components, with hyperechogenic areas, cystic spaces and acoustic shadows. This feature, which we consider pathognomonic, was present in 48/57 (84.2%) immature teratomas in which the solid components were adequately assessable. Conclusions: The typical ultrasound appearance of an ovarian immature teratoma is a large unilateral adnexal mass with large solid components that is poorly or moderately vascularized. The pathognomonic feature is heterogeneous echogenicity of the solid components with hyperechogenic areas, cystic spaces and acoustic shadows. Preoperative suspicion of immature teratoma can guide treatment, such as offering fertility-sparing surgery.</p>}},
  author       = {{Landolfo, C. and Froyman, W. and Testa, A. C. and Fischerova, D. and Franchi, D. and Yazbek, J. and Saso, S. and Fruscio, R. and Chiappa, V. and Czekierdowski, A. and Van Gorp, T. and Moro, F. and Savelli, L. and Zannoni, G. F. and Bourne, T. and Timmerman, D. and Valentin, L. and Guerriero, S. and Coosemans, A. and Van Holsbeke, C. and Sayasneh, A. and Helmy-Bader, S. and De Meis, L. and Del Forno, S. and Heremans, R. and Pascual, M. Angela and Piras, A. and Hovsepyan, L. and Hiett, A. K. and Verbakel, J. Y. and Van Nieuwenhuysen, E. and Seckl, M. and Vergote, I.}},
  issn         = {{0960-7692}},
  keywords     = {{ovarian immature teratoma; ovarian neoplasm; ultrasonography}},
  language     = {{eng}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Ultrasound in Obstetrics and Gynecology}},
  title        = {{Imaging in gynecological disease (29) : clinical and ultrasound features of primary ovarian immature teratoma}},
  url          = {{http://dx.doi.org/10.1002/uog.70111}},
  doi          = {{10.1002/uog.70111}},
  year         = {{2025}},
}

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Imaging in gynecological disease (29) : clinical and ultrasound features of primary ovarian immature teratoma