Computed tomography of ovarian masses

Area of Science:

• Radiology
• Oncology
• Gynecologic Pathology

Background:

• Ovarian tumors represent a significant challenge in gynecologic oncology.
• Accurate preoperative diagnosis of ovarian masses is crucial for appropriate patient management.
• Computed tomography (CT) is a widely used imaging modality for evaluating abdominal and pelvic pathologies.

Purpose of the Study:

• To evaluate the diagnostic utility and limitations of CT in differentiating benign and malignant ovarian tumors.
• To assess the CT characteristics of ovarian masses, focusing on the presence and features of solid components.

Main Methods:

• Retrospective analysis of CT images from 100 patients with 138 histologically confirmed ovarian masses.
• Review of imaging features including cystic and solid components, wall thickness, septations, and contrast enhancement.
• Correlation of CT findings with histological diagnoses.

Main Results:

• Purely cystic masses were predominantly benign (94.2%).
• A solid component was present in 4.8% of benign masses and 94% of malignant tumors.
• Benign solid tumors were indistinguishable from malignant tumors based on solid component size or enhancement.
• Krukenberg tumors exhibited large solid components (>50% of mass).

Conclusions:

• The presence of a solid component in an ovarian mass on CT raises suspicion for malignancy, though rare benign solid tumors exist.
• CT is valuable in identifying solid components but cannot definitively differentiate all benign from malignant solid ovarian tumors.
• Large solid components in ovarian masses on CT warrant further investigation, including upper gastrointestinal studies, to exclude Krukenberg tumors.