Pathogenesis and MRI findings in two cases of seromucinous borderline tumors coexisting with carcinoma in endometriotic cysts: Case reports and literature review

Pathogenesis and MRI findings in two cases of seromucinous borderline tumors coexisting with carcinoma in endometriotic cysts: Case reports and literature review Abstract Seromucinous borderline tumors (SMBTs) generally have a favorable prognosis, and fertility-preserving surgery may be indicated. However, SMBT may occasionally coexist with carcinoma, necessitating careful management. This report presents two cases of SMBT coexisting with carcinoma within endometriotic cysts and reviews pathogenesis mechanisms with MRI-pathological correlations. In both cases, SMBT components appeared as papillary or nodular projections with prominent high signal intensity on T2WI, no diffusion restriction on DWI, and gradual, weak enhancement on dynamic contrast-enhanced (DCE) MRI. In contrast, coexisting carcinoma components showed intermediate signal intensity on T2WI, diffusion restriction on DWI, and rapid, intense enhancement on DCE-MRI. As it affects prognosis and treatment strategy, assessing the coexistence of carcinoma with SMBT is essential. This is the first report to demonstrate the usefulness of multiparametric MRI, including DWI and DCE-MRI, in evaluating SMBT and coexisting carcinoma in endometriotic cysts. CONFLICT OF INTEREST STATEMENT The authors declare that they have no conflicts of interest. DATA AVAILABILITY STATEMENT The data supporting the findings of this study are available upon request from the corresponding author. However, these data are not publicly accessible due to privacy and ethical restrictions. The article includes information and images derived from clinical histories, which are subject to strict confidentiality requirements. To protect the privacy and confidentiality of patients, any data or information that could potentially compromise these safeguards is securely protected. For further inquiries or access to specific data, we encourage interested parties to contact the corresponding author or the relevant institution directly.