From the archives of the AFIP. Ovarian epithelial neoplasms: radiologic-pathologic correlation

Ovarian carcinoma is the most common cause of death from a gynecologic malignant neoplasm. The typically advanced stage at presentation and aggressive nature of these neoplasms result in an overall 5-year survival rate of less than 40%. Most malignant ovarian neoplasms are of the surface epithelial cell type, which includes serous, mucinous, clear cell, endometrioid, and Brenner tumors. However, among the epithelial neoplasms, benign lesions are more common than malignant neoplasms, and other entities (including nonneoplastic masses) are far more common causes of a pelvic mass. Imaging studies (ultra-sound, computed tomography, and magnetic resonance imaging) can depict the tumor morphology: solid or cystic, unilocular or multilocular cystic, with or without thickening of the walls or septa, with or without papillary excrescences or other soft-tissue elements, and with or without calcifications. Evaluation of these morphologic characteristics allows attempted differentiation among malignant, benign neoplastic, and nonneoplastic lesions. Lesion characterization assists in surgical planning. Malignant neoplasms nearly always require laparotomy, whereas benign neoplasms may be managed laparoscopically. In the case of ovarian carcinoma, treatment is primarily surgical, and most patients also receive chemotherapy. Unfortunately, recurrence is common.