Serous papillary cystadenofibroma combined with extended external genital endometriosis

In: Obstetrics, Gynecology and Reproduction · 2021 · vol. 14(6) , pp. 694–703 · doi:10.17749/2313-7347/ob.gyn.rep.2020.190 · W3119716239
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This case report describes the MRI and diagnostic findings of a rare combination of serous papillary cystadenofibroma with extensive external genital endometriosis and intratumoral hemorrhage.

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This paper reports a clinical case of a rare serous papillary cystadenofibroma (CAF) of the ovary occurring together with extended external genital endometriosis, including sequelae attributed to intra-tumoral hemorrhage. The authors describe how MRI—emphasizing high soft-tissue contrast and functional techniques such as diffusion-weighted imaging (DWI) and dynamic contrast enhancement (DCE)—and diagnostic laparoscopy were used to guide surgical planning and to support differential diagnosis while excluding malignancy transformation. A key finding is that the combined imaging characteristics were sufficient to distinguish the tumor from malignant transformation in this case. This paper does not provide a generalizable study design beyond the single-case narrative. This paper is centrally about endometriosis — it documents a rare coexistence of external genital endometriosis with serous papillary cystadenofibroma and discusses imaging features used to differentiate malignancy-related transformation in that context.

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Abstract

Ovarian cystadenofibroma (CAF) is a rare ovarian tumor originating both from epithelial and stromal components being, however, classified as epithelial tumors. CAF prevalence among all ovarian tumors does not exceed more than 1.7 %. CAFs are commonly asymptomatic, in extremely rare cases of large tumor or ovarian torsion pain sensation may be noted. External genital endometriosis (EGE) is a chronic gynecological disorder that occurs in women of reproductive age and cause infertility and pelvic pain. EGE prevalence comprises around 10 % in women of reproductive age, 20–50 % in women with infertility, and almost 90 % in women with chronic pelvic pain. Magnetic resonance imaging (MRI) is method of choice in diagnostics of such pathology due to the high natural soft tissue contrast and functional techniques such as diffusion-weighted images (DWI) and dynamic contrast enhancement (DCE). Surgery planning, necessity for systemic therapy or follow-up directly depend on imaging and diagnostic laparoscopy results. Here we present a clinical case of rarely combined serous papillary CAF with extended EGE accompanied with consequences of intra-tumoral hemorrhage. Case study demonstrates main visualization characteristics that provide correct differential diagnosis and exclude malignancy transformation.
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Abstract

Ovarian cystadenofibroma (CAF) is a rare ovarian tumor originating both from epithelial and stromal components being, however, classified as epithelial tumors. CAF prevalence among all ovarian tumors does not exceed more than 1.7 %. CAFs are commonly asymptomatic, in extremely rare cases of large tumor or ovarian torsion pain sensation may be noted. External genital endometriosis (EGE) is a chronic gynecological disorder that occurs in women of reproductive age and cause infertility and pelvic pain. EGE prevalence comprises around 10 % in women of reproductive age, 20–50 % in women with infertility, and almost 90 % in women with chronic pelvic pain. Magnetic resonance imaging (MRI) is method of choice in diagnostics of such pathology due to the high natural soft tissue contrast and functional techniques such as diffusion-weighted images (DWI) and dynamic contrast enhancement (DCE). Surgery planning, necessity for systemic therapy or follow-up directly depend on imaging and diagnostic laparoscopy results. Here we present a clinical case of rarely combined serous papillary CAF with extended EGE accompanied with consequences of intra-tumoral hemorrhage. Case study demonstrates main visualization characteristics that provide correct differential diagnosis and exclude malignancy transformation. About the Authors E. M. SyrkashevRussian Federation Egor M. Syrkashev – Researcher, Department of Radiology Scopus Author ID: 57204631271 4 Academika Oparina Str., Moscow 117997 A. E. Solopova Russian Federation Alina E. Solopova – MD, Dr Sci Med, Associate Professor, Leading Researcher, Department of Radiology Scopus Author ID: 24460923200. Researcher ID: P-8659-2015 4 Academika Oparina Str., Moscow 117997 A. V. Asaturova Russian Federation Alexandra V. Asaturova – MD, PhD, Senior Researcher, Department of Pathology Scopus Author ID: 57190118907 4 Academika Oparina Str., Moscow 117997

References

1. Cho S.-M., Byun J.Y., Rha S.E. et al. CT and MRI findings of cystadenofibromas of the ovary. Eur Radiol. 2004;14(5):798–804. https://doi.org/10.1007/s00330-003-2060-z. 2. Forstner R., Thomassin-Naggara I., Cunha T.M. et al. ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: an update. Eur Radiol. 2017;27(6):2248–57. https://doi.org/10.1007/s00330-016-4600-3. 3. Bazot M., Bharwani N., Huchon C. et al. European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis. Eur Radiol. 2017;27(7):2765–75. https://doi.org/10.1007/s00330-016-4673-z. 4. Chamie L.P., Blasbalg R., Pereira R.M.A. et al. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics. 2011;31(4):E77–100. https://doi.org/10.1148/rg.314105193. 5. Coutinho A.J., Bittencourt L.K., Pires C.E. et al. MR imaging in deep pelvic endometriosis: a pictorial essay. Radiographics. 2011;31(2):549–67. https://doi.org/10.1148/rg.312105144. 6. Bazot M., Lafont C., Rouzier R. et al. Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis. Fertil Steril. 2009;92(6):1825–33. https://doi.org/10.1016/j.fertnstert.2008.09.005. 7. Hsu A.L., Khachikyan I., Stratton P. Invasive and noninvasive methods for the diagnosis of endometriosis. Clin Obstet Gynecol. 2010;53(2):413–9. https://doi.org/10.1097/GRF.0b013e3181db7ce8. 8. Jimbo H., Yoshikawa H., Onda T. et al. Prevalence of ovarian endometriosis in epithelial ovarian cancer. Int J Gynaecol Obstet. 1997;59(3):245–50. https://doi.org/10.1016/s0020-7292(97)00238-5. 9. Chew S., Tham K.F., Ratnam S.S. A series of ovarian clear cell and endometrioid carcinoma and their association with endometriosis. Singapore Med J. 1997;38(7):289–91. 10. Heaps J.M., Nieberg R.K., Berek J.S. Malignant neoplasms arising in endometriosis. Obstet Gynecol. 1990;75(6):1023–8. 11. Corwin M.T., Gerscovich E.O., Lamba R. et al. Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology. 2014;271(1):126–32. https://doi.org/10.1148/radiol.13131394. 12. Foti P.V., Attina G., Spadola S. et al. MR imaging of ovarian masses: classification and differential diagnosis. Insights Imaging. 2016;7(1):21–41. https://doi.org/10.1007/s13244-015-0455-4. 13. Kuligowska E., Deeds L., Lu K. Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radiographics. 2005;25(1):3–20. https://doi.org/10.1148/rg.251045511. 14. Woodward P.J., Sohaey R., Mezzetti T.P.J. Endometriosis: radiologicpathologic correlation. Radiographics. 2001;21(1):193–4. https://doi.org/10.1148/radiographics.21.1.g01ja14193. 15. Minnulina N.K., Akhmetshina L.P. Clinical case: endometrial cysts with uncommon contents. [Klinicheskij sluchaj: endometrioidnye kisty s redkim soderzhimym]. Prakticheskaya medicina. 2016;(4–2):75–7. (In Russ.). 16. Foti P.V., Farina R., Palmucci S. et al. Endometriosis: clinical features, MR imaging findings and pathologic correlation. Insights Imaging. 2018;9(2):149–72. https://doi.org/10.1007/s13244-017-0591-0. 17. Scully R.E., Richardson G.S., Barlow J.F. The development of malignancy in endometriosis. Clin Obstet Gynecol. 1966;9(2):384–411. https://doi.org/10.1097/00003081-196606000-00008. 18. Nishida M., Watanabe K., Sato N., Ichikawa Y. Malignant transformation of ovarian endometriosis. Gynecol Obstet Invest. 2000;50(Suppl 1):18–25. https://doi.org/10.1159/000052874. 19. Tanaka Y.O., Yoshizako T., Nishida M. et al. Ovarian carcinoma in patients with endometriosis: MR imaging findings. Am J Roentgenol. 2000;175(5):1423–30. https://doi.org/10.2214/ajr.175.5.1751423. 20. Kao G.F., Norris H.J. Unusual cystadenofibromas: endometrioid, mucinous, and clear cell types. Obstet Gynecol. 1979;54(6):729–36. http://europepmc.org/abstract/MED/514560. 21. Byun J.Y. MR imaging findings of ovarian cystadenofibroma: clues for making the differential diagnosis from ovarian malignancy. Korean J Radiol. 2006;7(3):153–5. https://doi.org/10.3348/kjr.2006.7.3.153. 22. Tang Y.Z., Liyanage S., Narayanan P. et al.The MRI features of histologically proven ovarian cystadenofibromas – an assessment of the morphological and enhancement patterns. Eur Radiol. 2013;23(1):48–56. https://doi.org/10.1007/s00330-012-2568-1. 23. Jung S.E., Lee J.M., Rha S.E. et al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 2002;22(6):1305–25. https://doi.org/10.1148/rg.226025033. 24. Jung D.C., Kim S.H., Kim S.H. MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma: clues for the differential diagnosis. Korean J Radiol. 2006;7(3):199–204. https://doi.org/10.3348/kjr.2006.7.3.199. 25. Takeuchi M., Matsuzaki K., Nishitani H. Diffusion-weighted magnetic resonance imaging of ovarian tumors: differentiation of benign and malignant solid components of ovarian masses. J Comput Assist Tomogr. 2010;34(2):173–6. https://doi.org/10.1097/RCT.0b013e3181c2f0a2. 26. Thomassin-Naggara I., Darai E., Cuenod C.A. et al. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses. Eur Radiol. 2009;19(6):1544–52. https://doi.org/10.1007/s00330-009-1299-4. 27. Fujii S., Kakite S., Nishihara K. et al. Diagnostic accuracy of diffusionweighted imaging in differentiating benign from malignant ovarian lesions. J Magn Reson Imaging. 2008;28(5):1149–56. https://doi.org/10.1002/jmri.21575. 28. Thomassin-Naggara I., Darai E., Cuenod C.A. et al.Dynamic contrastenhanced magnetic resonance imaging: a useful tool for characterizing ovarian epithelial tumors. J Magn Reson Imaging. 2008;28(1):111–20. https://doi.org/10.1002/jmri.21377. 29. Ram M., Abdulla A., Razvi K. et al.Cystadenofibroma of the rete ovarii: a case report with review of literature. Rare Tumors. 2009;1(1):e24. https://doi.org/10.4081/rt.2009.e24. 30. Mannion E., O’Grady J.T., Al-Nafussi A.I. Metaplastic cystadenofibroma of the ovary. Histopathology. 1993;23(6):581–4. https://doi.org/10.1111/j.1365-2559.1993.tb01250.x. 31. Bohara S., Jain S., Khurana N. et al. Intraoperative cytology of ovarian neoplasms with an attempt to grade epithelial tumors. J Cytol. 2018;35(1):1–7. https://doi.org/10.4103/JOC.JOC_183_16. Review For citations: Syrkashev E.M., Solopova A.E., Asaturova A.V. Serous papillary cystadenofibroma combined with extended external genital endometriosis. Obstetrics, Gynecology and Reproduction. 2020;14(6):694-703. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.190 JATS XML This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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