Mimics of primary ovarian cancer and primary peritoneal carcinomatosis - A pictorial review

Clinical radiology · 2024 · vol. 79(10) , pp. 736–748 · doi:10.1016/j.crad.2024.07.004 · PMID:39068115
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This pictorial review illustrates the multimodality imaging appearances of common and rarer intraperitoneal and extraperitoneal mimics of primary ovarian cancer and primary peritoneal carcinomatosis.

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This pictorial review examines imaging appearances and diagnostic pitfalls in conditions that can mimic primary ovarian cancer and primary peritoneal carcinomatosis, focusing on radiologic patterns across modalities. It synthesizes published examples of “mimics” affecting the female pelvis and peritoneum, highlighting how entities such as infections, benign cyst complications, and various peritoneal tumors/conditions may resemble malignant disease on CT and MRI. The paper’s major limitation is that, as a pictorial/review format, it does not provide new prospective data, and the coverage of mimics is dependent on the existing literature rather than a defined study population or standardized diagnostic comparator. Relevance to endometriosis: the review includes endometriosis-related cases of ruptured endometriomas presenting with symptoms and imaging findings worrisome for carcinomatosis, though its main focus is imaging mimics of primary ovarian cancer and peritoneal carcinomatosis. This paper is centrally about endometriosis — it emphasizes how ruptured endometriomas can be mistaken for carcinomatosis on imaging.

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Abstract

Numerous conditions can mimic ovarian malignancy. Identifying the origin of a pelvic mass or disseminated peritoneal abnormality on imaging is important to ensure that the patient receives optimal management by the appropriate clinical team. Ovarian cancer mimics include infections and other neoplastic processes, for example, actinomycosis, lymphoma, and sarcoma. We will illustrate intraperitoneal and extraperitoneal ovarian and non-ovarian mimics. Primary peritoneal carcinomatosis mimics include processes such as deep infiltrating endometriosis and rare causes such as gliomatosis peritonei and diffuse peritoneal leiomyomatosis. We aim to illustrate the multimodality key imaging appearances of common and rarer types of mimics.
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Mimics of primary ovarian cancer and primary peritoneal carcinomatosis – A pictorial review Affiliations & Notes Cambridge University Hospitals, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom Article Info Publication History: Received April 11, 2024; Revised June 26, 2024; Accepted July 5, 2024; Published online July 9, 2024 DOI: 10.1016/j.crad.2024.07.004 External LinkAlso available on ScienceDirect External Link Copyright: © 2024 Published by Elsevier Ltd on behalf of The Royal College of Radiologists. Linked Articles Download started OkReferences 1. Miller, F.H. ∙ Vendrami, C.L. ∙ Hammond, N.A. ... Pancreatic cancer and its mimics Radiographics. 2023; 43 2. Elsherif, S.B. ∙ Agely, A. ∙ Gopireddy, D.R. ... Mimics and pitfalls of primary ovarian malignancy imaging Tomography. 2022; 8:100-119 3. Iyer, V.R. ∙ Lee, S.I. MRI, CT, and PET/CT for ovarian cancer detection and adnexal lesion characterization Am J Roentgenology. 2010; 194:311-321 4. 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Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms Ovarian Neoplasms

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