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Imaging in gynecological disease (13) : clinical and ultrasound characteristics of endometrioid ovarian cancer

Moro, F.; Magoga, G.; Pasciuto, T.; Mascilini, F.; Moruzzi, M. C.; Fischerova, D.; Savelli, L.; Giunchi, S.; Mancari, R. and Franchi, D., et al. (2018) In Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology 52(4). p.535-543
Abstract

OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure endometrioid carcinomas.

METHODS: This was a retrospective multicenter study of patients with a histological diagnosis of pure endometrioid carcinoma. We identified 161 patients from the International Ovarian Tumor Analysis (IOTA) database who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016, and another 78 patients from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. In addition, one author reviewed all available ultrasound images and described them using pattern recognition.

RESULTS: Median... (More)

OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure endometrioid carcinomas.

METHODS: This was a retrospective multicenter study of patients with a histological diagnosis of pure endometrioid carcinoma. We identified 161 patients from the International Ovarian Tumor Analysis (IOTA) database who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016, and another 78 patients from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. In addition, one author reviewed all available ultrasound images and described them using pattern recognition.

RESULTS: Median age of the 239 patients was 55 years (range, 19-88 years). On ultrasound examination, two (0.8%) endometrioid carcinomas were described as unilocular cysts, three (1.3%) as multilocular cysts, 37 (15.5%) as unilocular-solid cysts, 115 (48.1%) as multilocular-solid cysts and 82 (34.3%) as solid masses. Median largest tumor diameter was 102.5 mm (range, 20-300 mm) and median largest diameter of the largest solid component was 63 mm (range, 9-300 mm). Papillary projections were present in 70 (29.3%) masses. Most cancers (188 (78.7%)) were unilateral. In 49 (20.5%) cases, the cancer was judged by the pathologist to develop from endometriosis. These cancers, compared with those without evidence of tumor developing from endometriosis, more often manifested papillary projections on ultrasound (46.9% (23/49) vs 24.7% (47/190)), were less often bilateral (8.2% (4/49) vs 24.7% (47/190)) and less often associated with ascites (6.1% (3/49) vs 28.4% (54/190)) and fluid in the pouch of Douglas (24.5% (12/49) vs 48.9% (93/190)). Retrospective analysis of available ultrasound images using pattern recognition revealed that many tumors without evidence of tumor developing from endometriosis (36.3% (41/113)) had a large central solid component entrapped within locules, giving the tumor a cockade-like appearance.

CONCLUSIONS: Endometrioid cancers are usually large, unilateral, multilocular-solid or solid tumors. The ultrasound characteristics of endometrioid carcinomas developing from endometriosis differ from those without evidence of tumor developing from endometriosis, the former being more often unilateral cysts with papillary projections and no ascites.

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keywords
endometrioid ovarian carcinoma, ovarian neoplasms, ultrasonography
in
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
volume
52
issue
4
pages
9 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:85054382012
ISSN
1469-0705
DOI
10.1002/uog.19026
language
English
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yes
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d8ed7219-2840-4a9a-9677-1981e133f824
date added to LUP
2018-11-01 12:18:19
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2019-07-16 03:59:31
@article{d8ed7219-2840-4a9a-9677-1981e133f824,
  abstract     = {<p>OBJECTIVE: To describe the clinical and ultrasound characteristics of ovarian pure endometrioid carcinomas.</p><p>METHODS: This was a retrospective multicenter study of patients with a histological diagnosis of pure endometrioid carcinoma. We identified 161 patients from the International Ovarian Tumor Analysis (IOTA) database who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016, and another 78 patients from the databases of the departments of gynecological oncology in the participating centers. All tumors were described using IOTA terminology. In addition, one author reviewed all available ultrasound images and described them using pattern recognition.</p><p>RESULTS: Median age of the 239 patients was 55 years (range, 19-88 years). On ultrasound examination, two (0.8%) endometrioid carcinomas were described as unilocular cysts, three (1.3%) as multilocular cysts, 37 (15.5%) as unilocular-solid cysts, 115 (48.1%) as multilocular-solid cysts and 82 (34.3%) as solid masses. Median largest tumor diameter was 102.5 mm (range, 20-300 mm) and median largest diameter of the largest solid component was 63 mm (range, 9-300 mm). Papillary projections were present in 70 (29.3%) masses. Most cancers (188 (78.7%)) were unilateral. In 49 (20.5%) cases, the cancer was judged by the pathologist to develop from endometriosis. These cancers, compared with those without evidence of tumor developing from endometriosis, more often manifested papillary projections on ultrasound (46.9% (23/49) vs 24.7% (47/190)), were less often bilateral (8.2% (4/49) vs 24.7% (47/190)) and less often associated with ascites (6.1% (3/49) vs 28.4% (54/190)) and fluid in the pouch of Douglas (24.5% (12/49) vs 48.9% (93/190)). Retrospective analysis of available ultrasound images using pattern recognition revealed that many tumors without evidence of tumor developing from endometriosis (36.3% (41/113)) had a large central solid component entrapped within locules, giving the tumor a cockade-like appearance.</p><p>CONCLUSIONS: Endometrioid cancers are usually large, unilateral, multilocular-solid or solid tumors. The ultrasound characteristics of endometrioid carcinomas developing from endometriosis differ from those without evidence of tumor developing from endometriosis, the former being more often unilateral cysts with papillary projections and no ascites.</p>},
  author       = {Moro, F. and Magoga, G. and Pasciuto, T. and Mascilini, F. and Moruzzi, M. C. and Fischerova, D. and Savelli, L. and Giunchi, S. and Mancari, R. and Franchi, D. and Czekierdowski, A. and Froyman, W. and Verri, D. and Epstein, E. and Chiappa, V. and Guerriero, S. and Zannoni, G. F. and Timmerman, D. and Scambia, G. and Valentin, L. and Testa, A. C.},
  issn         = {1469-0705},
  keyword      = {endometrioid ovarian carcinoma,ovarian neoplasms,ultrasonography},
  language     = {eng},
  number       = {4},
  pages        = {535--543},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology},
  title        = {Imaging in gynecological disease (13) : clinical and ultrasound characteristics of endometrioid ovarian cancer},
  url          = {http://dx.doi.org/10.1002/uog.19026},
  volume       = {52},
  year         = {2018},
}