CT and MR Imaging of Malignant Germinal and Stromal Ovarian Tumours

  • Corinne Balleyguier
  • Wassef Khaled
  • Sandra Canale
  • Laura Ciolovan
  • Elise Zareski
  • Pierre Duvillard
  • Laurence Brugières
  • Philippe Morice
Chapter

Abstract

Malignant germ cell tumours are less common than epithelial ovarian tumours, accounting for less than 2–3 % of all ovarian cancers in Western countries. They usually occur in younger women with a peak incidence before 20 years.

Malignant stromal tumours are developed on stromal tissue of the ovary and are frequently associated with hormonal secretion. In this group, malignant lesions are most represented by adult or juvenile granulosa cell tumours, Sertoli-Leydig tumours and fibrosarcoma.

Imaging and in particular CT and MR may help to characterise and to stage preoperatively these rare tumours, and besides common malignant features, it might be useful to detect some specific features to better assess these lesions.

Keywords

Malignant ovarian germ cell Choriocarcinoma Embryonal carcinoma Imaging Computed tomography Magnetic resonance imaging 

References

  1. 1.
    Outwater EK, Siegelman ES, Hunt JL. Ovarian teratomas: tumor types and imaging characteristics. Radiographics. 2001;21(2):475–90.PubMedCrossRefGoogle Scholar
  2. 2.
    Choudhary S, Fasih N, Mc Innes M, Marginean C. Imaging of ovarian teratomas: appearances and complications. J Med Imaging Radiat Oncol. 2009;53(5):480–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Saba L, Guerriero S, Sulcis R, Virgilio B, Melis G, Mallarini G. Mature and immature ovarian teratomas: CT, US and MR imaging characteristics. Eur J Radiol. 2009;72(3):454–63.PubMedCrossRefGoogle Scholar
  4. 4.
    Yamaoka T, Togashi K, Koyama T, Fujiwara T, Higuchi T, Iwasa Y, et al. Immature teratoma of the ovary: correlation of MR imaging and pathologic findings. Eur Radiol. 2003;13(2):313–9.PubMedGoogle Scholar
  5. 5.
    Bazot M, Cortez A, Sananes S, Boudghene F, Uzan S, Bigot JM. Imaging of dermoid cysts with foci of immature tissue. J Comput Assist Tomogr. 1999;23(5):703–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Hackethal A, Brueggmann D, Bohlmann MK, Franke FE, Tinneberg HR, Munstedt K. Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data. Lancet Oncol. 2008;9(12):1173–80.PubMedCrossRefGoogle Scholar
  7. 7.
    Buy JN, Ghossain MA, Moss AA, Bazot M, Doucet M, Hugol D, et al. Cystic teratoma of the ovary: CT detection. Radiology. 1989;171(3):697–701.PubMedGoogle Scholar
  8. 8.
    Kido A, Togashi K, Konishi I, Kataoka ML, Koyama T, Ueda H, et al. Dermoid cysts of the ovary with malignant transformation: MR appearance. AJR Am J Roentgenol. 1999;172(2):445–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Nimkin K, Gupta P, McCauley R, Gilchrist BF, Lessin MS. The growing teratoma syndrome. Pediatr Radiol. 2004;34(3):259–62.PubMedCrossRefGoogle Scholar
  10. 10.
    Itani Y, Kawa M, Toyoda S, Yamagami K, Hiraoka K. Growing teratoma syndrome after chemotherapy for a mixed germ cell tumor of the ovary. J Obstet Gynaecol Res. 2002;28(3):166–71.PubMedCrossRefGoogle Scholar
  11. 11.
    Yamaoka T, Togashi K, Koyama T, Ueda H, Nakai A, Fujii S, et al. Yolk sac tumor of the ovary: radiologic-pathologic correlation in four cases. J Comput Assist Tomogr. 2000;24(4):605–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Choi HJ, Moon MH, Kim SH, Cho JY, Jung DC, Hong SR. Yolk sac tumor of the ovary: CT findings. Abdom Imaging. 2008;33(6):736–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Levitin A, Haller KD, Cohen HL, Zinn DL, O’Connor MT. Endodermal sinus tumor of the ovary: imaging evaluation. AJR Am J Roentgenol. 1996;167(3):791–3.PubMedCrossRefGoogle Scholar
  14. 14.
    Matsubayashi R, Matsuo Y, Doi J, Kudo S, Matsuguchi K, Sugimori H. Sclerosing stromal tumor of the ovary: radiologic findings. Eur Radiol. 1999;9(7):1335–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumours with emphasis on differential diagnosis. Radiographics. 2002;22(6):1305–25.PubMedCrossRefGoogle Scholar
  16. 16.
    Moniaga NC, Randall LM. Malignant mixed ovarian germ cell tumor with embryonal component. J Pediatr Adolesc Gynecol. 2011;24(1):e1–3.PubMedCrossRefGoogle Scholar
  17. 17.
    Lalwani N, Shanbhogue AK, Bhargava P, Vikram R, Prasad SR. Rare, miscellaneous primary ovarian neoplasms: spectrum of cross-sectional imaging. Curr Probl Diagn Radiol. 2012;41(2):73–80.PubMedCrossRefGoogle Scholar
  18. 18.
    Bazot M, Cortez A, Sananes S, Buy JN. Imaging of pure primary ovarian choriocarcinoma. AJR Am J Roentgenol. 2004;182(6):1603–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Brammer 3rd HM, Buck JL, Hayes WS, Sheth S, Tavassoli FA. From the archives of the AFIP. Malignant germ cell tumours of the ovary: radiologic-pathologic correlation. Radiographics. 1990;10(4):715–24.PubMedCrossRefGoogle Scholar
  20. 20.
    Tanaka YO, Kurosaki Y, Nishida M, Michishita N, Kuramoto K, Itai Y, et al. Ovarian dysgerminoma: MR and CT appearance. J Comput Assist Tomogr. 1994;18(3):443–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Lazebnik N, Balog A, Bennett S, Redline R, Liu J. Ovarian dysgerminoma: a challenging clinical and sonographic diagnosis. J Ultrasound Med. 2009;28(10):1409–15.PubMedGoogle Scholar
  22. 22.
    Guerriero S, Testa AC, Timmerman D, Van Holsbeke C, Ajossa S, Fischerova D, et al. Imaging of gynecological disease (6): clinical and ultrasound characteristics of ovarian dysgerminoma. Ultrasound Obstet Gynecol. 2011;37(5):596–602.PubMedCrossRefGoogle Scholar
  23. 23.
    Kim SH, Kang SB. Ovarian dysgerminoma: color Doppler ultrasonographic findings and comparison with CT and MR imaging findings. J Ultrasound Med. 1995;14(11):843–8.PubMedGoogle Scholar
  24. 24.
    Shanbhogue AK, Shanbhogue DK, Prasad SR, Surabhi VR, Fasih N, Menias CO. Clinical syndromes associated with ovarian neoplasms: a comprehensive review. Radiographics. 2010;30(4):903–19.PubMedCrossRefGoogle Scholar
  25. 25.
    Jung SE, Rha SE, Lee JM, Park SY, Oh SN, Cho KS, et al. CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol. 2005;185(1):207–15.PubMedCrossRefGoogle Scholar
  26. 26.
    Azuma A, Koyama T, Mikami Y, Tamai K, Fujimoto K, Morisawa N, et al. A case of Sertoli-Leydig cell tumor of the ovary with a multilocular cystic appearance on CT and MR imaging. Pediatr Radiol. 2008;38(8):898–901.PubMedCrossRefGoogle Scholar
  27. 27.
    Choi WJ, Ha MT, Shin JK, Lee JH. Primary ovarian fibrosarcoma with long-term survival: a report of two cases. J Obstet Gynaecol Res. 2006;32(5):524–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Prat J, Scully RE. Cellular fibromas and fibrosarcomas of the ovary: a comparative clinicopathologic analysis of seventeen cases. Cancer. 1981;47(11):2663–70.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Corinne Balleyguier
    • 1
  • Wassef Khaled
    • 1
  • Sandra Canale
    • 1
  • Laura Ciolovan
    • 1
  • Elise Zareski
    • 1
  • Pierre Duvillard
    • 2
  • Laurence Brugières
    • 3
  • Philippe Morice
    • 4
  1. 1.Radiology DepartmentInstitut Gustave RoussyVillejuifFrance
  2. 2.Biopathology DepartmentInstitut Gustave RoussyVillejuifFrance
  3. 3.Pediatry DepartmentInstitut Gustave RoussyVillejuifFrance
  4. 4.Surgery DepartmentInstitut Gustave RoussyVillejuifFrance

Personalised recommendations