Ovarian serous surface papillary borderline tumors form sea anemone-like masses

To clarify the imaging characteristics of ovarian serous surface papillary borderline tumor (SSPBT), whose prognosis is far better than that of serous surface papillary adenocarcinoma (SSPC).

We retrospectively reviewed the clinical and imaging findings of six cases (age range, 26-58 years; mean, 43 years) with SSPBT encountered at our institute from 1996 to 2008.

Serum levels of CA125 were elevated, and they were clinically suspected to have ovarian cancer. All masses were almost entirely solid and showed hyperintense papillary architecture with hypointense internal branching on T2-weighted MRI. Five patients had peritoneal implants, and two had lymph node enlargement, and all tumors were accompanied by ascites. In all cases, contralateral ovaries had cystic masses with mural nodules or mixed solid and cystic masses, of which the solid part was similar to the contralateral mass. No evidence of recurrence was noted at a follow-up of >12 months postoperatively.

SSPBT, which has more favorable prognosis than those of flank ovarian carcinoma, is characterized by a solid mass with papillary architecture and internal branching resembling a sea anemone on MR.