Malignant transformation of an endometriotic cyst: MDCT and MR findings

Tsili AC, Athina C. Tsili, Argyropoulou MI, Maria I. Argyropoulou, Koliopoulos G, George Koliopoulos, Evangelos Paraskevaidis, Paraskevaidis E, Konstantine Tsampoulas, Tsampoulas K
Journal of radiology case reports · 2011 · vol. 5(1) , pp. 9–17 · doi:10.3941/jrcr.v5i1.435 · PMID:22470759 · PMC3303415 · W2067131258
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Multidetector CT and MR imaging demonstrated an endometrioid adenocarcinoma within an ovarian endometrioma, with MR findings including soft-tissue components, contrast enhancement, and restricted diffusion strongly suggesting malignancy.

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This case report describes the imaging characteristics of malignant transformation within an endometriotic cyst in a thirty-year-old woman. Multidetector CT and magnetic resonance imaging revealed soft-tissue components with strong, early enhancement after contrast administration, alongside restricted diffusion on diffusion-weighted images. These radiological features allowed for the correct preoperative characterization of the lesion as an endometrioid adenocarcinoma arising from an ovarian endometrioma. This paper is centrally about endometriosis — specifically the rare complication of malignant transformation of an endometriotic cyst into carcinoma.

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Abstract

Malignant transformation is a rare complication of endometriosis. MR criteria for diagnosis include the presence of soft-tissue components, enhancement after contrast material administration in an endometriotic cyst. We present the multidetector CT and MR imaging findings in a case of an incidentally found endometrioid adenocarcinoma in a left-sided ovarian endometrioma, occurring in a 30-year old woman. MR imaging enabled the correct preoperative characterization of the lesion, by depicting a soft-tissue element, with strong and early enhancement after gadolinium administration. The same area had high signal intensity on diffusion-weighted images and low apparent diffusion coefficient values due to restricted diffusion, findings also strongly suggestive of malignancy.
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Malignant transformation of an endometriotic cyst: MDCT and MR findings DOI: https://doi.org/10.3941/jrcr.v5i1.435Keywords: endometriosis, endometriotic cyst, carcinoma, imaging, multidetector CT, magnetic resonanceAbstract Malignant transformation is a rare complication of endometriosis. MR criteria for diagnosis include the presence of soft-tissue components, enhanciment after contrast material administration in an endometriotic cyst. We present the multidetector CT and MR imaging findings in a case of an incidentally found endometrioid adenocarcinoma in a left-sided ovarian endometrioma, occurring in a 30-year old woman. MR imaging enabled the correct preoperative characterization of the lesion, by depicting a soft-tissue element, with strong and early enhancement after gadolinium administration. The same area had high signal intensity on diffusion-weighted images and low apparent diffusion coefficient values due to restricted diffusion, findings also strongly suggestive of malignancy.Downloads Published 2011-01-22 Issue Section Genitourinary Radiology License The publisher holds the copyright to the published articles and contents. However, the articles in this journal are open-access articles distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License, which permits reproduction and distribution, provided the original work is properly cited. The publisher and author have the right to use the text, images and other multimedia contents from the submitted work for further usage in affiliated programs. Commercial use and derivative works are not permitted, unless explicitly allowed by the publisher.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Carcinoma, Endometrioid Endometriosis Ovarian Neoplasms Uterine Diseases Adult Adult Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Cell Transformation, Neoplastic Cell Transformation, Neoplastic Contrast Media Contrast Media Diffusion Magnetic Resonance Imaging Diffusion Magnetic Resonance Imaging Endometriosis Endometriosis Endometriosis Female Female

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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