Ovarian Carcinoma in Patients with Endometriosis

Y O Tanaka, Yumiko Tanaka, Takeshi Yoshizako, T Yoshizako, M Nishida, Masato Nishida, Masayuki Yamaguchi, M Yamaguchi, K Sugimura, Kazuro Sugimura, Y Itai, Yuji Itai
AJR. American journal of roentgenology · 2000 · vol. 175(5) , pp. 1423–1430 · doi:10.2214/ajr.175.5.1751423 · PMID:11044056 · W1750664464
article OA: closed CC0 ⤵ 86 in-corpus citations
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This study evaluated contrast-enhanced MR imaging sequences to identify enhancing mural nodules and other characteristics of malignant transformation in ovarian endometriosis, finding that dynamic subtraction imaging best revealed nodules in malignant endometriomas.

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Abstract

OBJECTIVE: Various types of malignancy can develop in patients with endometriosis. Enhancing mural nodules have been reported as an imaging characteristic of malignant transformations. We evaluated contrast-enhanced MR imaging to determine the optimum sequence to reveal mural nodules and other characteristics of malignant transformations. MATERIALS AND METHODS: We examined 10 patients with pathologically proven ovarian adenocarcinoma in endometriosis and 10 patients (the control group) with ovarian endometrioma suggestive of malignant transformation on the basis of sonographic findings. We analyzed the size and nature of the endometriomas in each patient. We compared four types of contrast-enhanced MR imaging to determine which sequence best revealed mural nodules. RESULTS: In the malignant and control groups, 80% of the cysts with findings suggestive of malignant transformation showed unilateral disease or larger endometrial cysts on the suggestive side than on the contralateral side. High signal intensity on T1-weighted images and low signal intensity on T2-weighted images relative to the myometrium were observed only in two of 10 malignant endometrial cysts and in all control cysts. All malignant endometriomas had small mural nodules with low signal intensity on T1-weighted contrast-enhanced images. Only three benign endometriomas had mural nodules and none of them enhanced. The enhancement of mural nodules was easily seen on dynamic subtraction imaging. CONCLUSION: On the basis of our findings, endometrial cysts with malignant transformation rarely show low signal intensity on T2-weighted images and usually have enhancing mural nodules. Because the enhancement of mural nodules is often difficult to evaluate on conventional T1-weighted images, dynamic subtraction imaging can be valuable.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Adenocarcinoma Endometriosis Magnetic Resonance Imaging Ovarian Neoplasms Adenocarcinoma Adenocarcinoma Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adult Cell Transformation, Neoplastic Cell Transformation, Neoplastic Contrast Media Endometriosis Endometriosis Endometrium Endometrium Female Follow-Up Studies Gadolinium DTPA

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.

References (24)

Cited by (50)

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