Clinical and imaging features in patients with endometriotic cyst suspected endometriosis associated ovarian cancer.

Kozue Asato, Chiaki Yagi, Keiko Mekaru, Morihiko Inamine, Yoichi Aoki
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2012 · vol. 28(2) , pp. 656–661 · doi:10.5180/jsgoe.28.656 · W2313305476
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study retrospectively analyzed six patients with suspected endometriotic cyst-associated ovarian cancer, finding that mural nodules without clear enhancement on T1-weighted contrast-enhanced images had low malignant potential.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This retrospective study examined clinical and MRI imaging features in six patients who underwent laparotomy for suspected endometriosis-associated ovarian cancer based on findings such as mural nodules or lack of T2 shading, but were confirmed pathologically not to have ovarian cancer. The authors reported that despite suspicion signals—including mural nodules on MRI or absent shading on T2-weighted images, and older age—the mural nodules in these patients were not clearly enhanced on T1-weighted contrast-enhanced images or had unclear enhancement, and they contained benign material such as fibrotic tissue, edematous stroma, and clots. A key limitation is the very small sample size (n=6) and the study’s selection of only those who proceeded to laparotomy, which may not represent the broader population of endometriotic cysts. This paper is centrally about endometriosis—specifically endometriotic cyst imaging features used to assess suspected malignant transformation into ovarian cancer.

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Abstract

Malignant transformation of endometriotic cyst occurs in approximately 0.7% cases. Although mural nodules are considered the most valuable imaging finding in diagnosis of ovarian cancers associated with endometriotic cyst, they are difficult to distinguish from clots with endometriotic cyst. Therefore, we often perform laparotomy for benign endometriotic cyst to rule out ovarian cancer. We selected six patients who underwent laparotomy for suspected ovarian cancer associated with endometriotic cyst, but who were confirmed not to have ovarian cancer pathologically. We retrospectively studied the clinical and imaging features of these six patients. We suspected malignant transformation of endometriotic cyst in patients with mural nodules on MRI or absence of shading on T2-weighted images as well as in older patients, however, mural nodules in the six patients were not enhanced or had unclear enhancements on T1-weighted contrast-enhanced images; all nodules showed benign contents such as fibrotic tissue, edematous stroma, and clots. Our study showed that mural nodules which are not clearly enhanced T1-weighted contrast-enhanced image appear to have low potential for malignancy. Therefore, in such cases, careful diagnosis using the dynamic subtraction study and minimally invasive surgery such as laparoscopy may be considerd.
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Original article Clinical and imaging features in patients with endometriotic cyst suspected endometriosis associated ovarian cancer. 2012 Volume 28 Issue 2 Pages 656-661 Details Abstract Malignant transformation of endometriotic cyst occurs in approximately 0.7% cases. Although mural nodules are considered the most valuable imaging finding in diagnosis of ovarian cancers associated with endometriotic cyst, they are difficult to distinguish from clots with endometriotic cyst. Therefore, we often perform laparotomy for benign endometriotic cyst to rule out ovarian cancer. We selected six patients who underwent laparotomy for suspected ovarian cancer associated with endometriotic cyst, but who were confirmed not to have ovarian cancer pathologically. We retrospectively studied the clinical and imaging features of these six patients. We suspected malignant transformation of endometriotic cyst in patients with mural nodules on MRI or absence of shading on T2-weighted images as well as in older patients, however, mural nodules in the six patients were not enhanced or had unclear enhancements on T1-weighted contrast-enhanced images; all nodules showed benign contents such as fibrotic tissue, edematous stroma, and clots. Our study showed that mural nodules which are not clearly enhanced T1-weighted contrast-enhanced image appear to have low potential for malignancy. Therefore, in such cases, careful diagnosis using the dynamic subtraction study and minimally invasive surgery such as laparoscopy may be considerd. © 2012 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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endometriosis

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