A New Insight on Exophytic Serous Borderline Adnexal Tumors: Specific Sonographic Features

Area of Science:

• Gynecologic oncology
• Medical imaging
• Ovarian pathology

Background:

• Exophytic serous borderline ovarian tumors (ESBOT) share sonographic similarities with high-grade serous carcinoma (HGSC).
• Accurate differentiation is crucial for appropriate patient management and surgical planning.

Purpose of the Study:

• To characterize and compare the sonographic features of ESBOT and HGSC.
• To identify specific imaging markers for distinguishing between these two ovarian tumor types.

Main Methods:

• Retrospective analysis of sonographic imaging in seven ESBOT and ten HGSC cases with exophytic growth patterns.
• Characterization of masses using International Ovarian Tumor Analysis (IOTA) terms and color Doppler assessment.

Main Results:

• ESBOT cases showed unilateral irregular solid masses with clear ovarian demarcation, tiny cystic inclusions, and calcifications.
• A unique intratumoral vascular bundle with radial blood flow was observed in ESBOT, absent in HGSC (P < .001).
• ESBOT frequently presented with unilocular-solid components (42.8%), while HGSC predominantly showed multilocular-solid morphology (P < .001).

Conclusions:

• ESBOT exhibits distinct B-mode and color Doppler sonographic features that differentiate it from HGSC.
• These sonographic characteristics can aid in preoperative diagnosis and guide intervention strategies for ovarian tumors.