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Frontiers in Medicine 2023Ovarian leiomyomas (OLs) are rare and account for only 0.5 to 1% of benign ovarian tumors. This study investigated the ultrasonographic manifestations of OL and the...
OBJECTIVES
Ovarian leiomyomas (OLs) are rare and account for only 0.5 to 1% of benign ovarian tumors. This study investigated the ultrasonographic manifestations of OL and the potential reasons for misdiagnosis.
METHODS
Between July 2018 and July 2023, 7 patients diagnosed with OL by surgical pathology and immunohistochemistry were enrolled in this retrospective analysis. Ultrasound (US) examinations were performed before surgery. Clinical characteristics, pathological findings, ultrasonographic manifestations, and treatment were reviewed.
RESULTS
The mean age of the 7 patients was 39.0 ± 11.57 years, with a disease course of 0.1 to 24 months. All ovarian leiomyomas were unilateral. Four cases occurred in the right ovary, and three cases occurred in the left ovary. All lesions presented as hypoechogenic, well-circumscribed, round or oval in shape, and regular in morphology. No significant blood flow signal was detected peripheral to or inside the mass in 3 cases (42.8%), and a minimal flow signal was detected peripheral to or inside the mass in 4 cases (58.2%). A total of 7 ultrasonographic images of OL were misdiagnosed: 1 patient was misdiagnosed with subserosal uterine leiomyoma, and 6 patients were misdiagnosed with a tumor in the ovarian thecoma-fibroma group.
CONCLUSION
The imaging manifestation of OL lacks specificity; thus, preoperatively distinguishing OL from other ovarian tumors and subserosal uterine leiomyomas is difficult. Immunohistochemistry may be helpful for the definitive diagnosis of OL. The possibility of ovarian leiomyoma should be considered in patients with uterine leiomyomas coexisting with an adnexal ovarian solid mass.
PubMed: 38213912
DOI: 10.3389/fmed.2023.1289522 -
Proceedings (Baylor University. Medical... Jul 2020Although rare, fibroepithelial polyp of the ureter is the most common type of benign urinary tract mesodermal tumor. It may cause symptoms such as hematuria, dysuria,...
Although rare, fibroepithelial polyp of the ureter is the most common type of benign urinary tract mesodermal tumor. It may cause symptoms such as hematuria, dysuria, and flank pain or be asymptomatic. Here we report incidental intraoperative detection of a left ureteral fibroepithelial polyp during an elective gyno-oncological surgery for left-sided ovarian thecoma.
PubMed: 33100571
DOI: 10.1080/08998280.2020.1783968 -
Abdominal Imaging Jun 2015To retrospectively evaluate the conventional and functional (diffusion- or perfusion-weighted) magnetic resonance (MR) imaging features of ovarian fibroma, fibrothecoma,...
OBJECTIVE
To retrospectively evaluate the conventional and functional (diffusion- or perfusion-weighted) magnetic resonance (MR) imaging features of ovarian fibroma, fibrothecoma, and thecoma.
MATERIALS AND METHODS
Histologically proven ovarian fibromas (n = 19), fibrothecomas (n = 7), and thecomas (n = 2) were reviewed (26 patients). The morphologic and signal intensity (SI) characteristics on conventional MR imaging (n = 28, all cases) were analyzed. The b 1000 signal intensity on diffusion-weighted image (DWI) (n = 22) and the time-to-signal intensity curve on perfusion-weighted image (PWI) (n = 7) were also analyzed. The presence and shape of the ipsilateral ovarian tissue surrounding the lesions were evaluated on T2-weighted image.
RESULTS
Twenty-two cases (79%) were predominantly solid tumor. Majority of the detected lesions exhibited the characteristic homogeneous low SI on T1- (24/28, 86%) and T2- (19/28, 68%) weighted image. Conversely, a number of lesions exhibited high SI (9/28, 32%) on T2-weighted image. Most lesions presented with a detectable ipsilateral ovary on T2-weighted image (24/28, 86%). Tumors larger than 6 cm more likely showed atypical morphology (mixed solid and cystic, cystic), atypical SI (high on T1- and T2-weighted image), and large amount ascites. Larger tumor group (>6 cm) was more likely diagnosed as fibrothecoma or thecoma than fibroma by pathology. On DWI, 16 lesions showed low b 1000 signal intensity (16/22, 73%). On PWI, all lesions showed curve type 1 or 2 (7/7, 100%), which tends to characterize benign lesions. All (16/16, 100%) pre-menopausal women had a detectable ipsilateral ovary, and six (60%) out of 10 post-menopausal women had a detectable ipsilateral ovary (p < 0.05).
CONCLUSIONS
Combining conventional morphologic and signal intensity characteristics with the findings from DWI or PWI might help differentiate ovarian fibroma, fibrothecoma, and thecoma from ovarian malignancy, although further prospective larger scale study using DWI and PWI is needed.
Topics: Adult; Female; Fibroma; Humans; Magnetic Resonance Imaging; Middle Aged; Ovarian Neoplasms; Thecoma
PubMed: 25273949
DOI: 10.1007/s00261-014-0257-z -
Magnetic Resonance Imaging Clinics of... Feb 2023MR imaging is useful in the detection and characterization of adnexal lesions. This review discusses the clinical findings and MR imaging appearances of two types of... (Review)
Review
MR imaging is useful in the detection and characterization of adnexal lesions. This review discusses the clinical findings and MR imaging appearances of two types of ovarian neoplasms: germ cell and sex cord stromal tumors. The most common of these lesions, mature cystic teratomas, is characterized by the presence of bulk fat on MR imaging. Some of the other germ cell neoplasms and sex cord stromal tumors may have suggestive clinical, laboratory, or MR imaging features (eg, lipid and fibrosis) to establish a diagnosis. The ability to differentiate benign tumors from possible malignancy can aid in patient management.
Topics: Female; Humans; Magnetic Resonance Imaging; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Sex Cord-Gonadal Stromal Tumors
PubMed: 36368863
DOI: 10.1016/j.mric.2022.07.003 -
Pathology Apr 2018
Topics: Aged; Cystadenoma, Serous; Female; Humans; Neoplasms, Multiple Primary; Ovarian Neoplasms; Thecoma
PubMed: 29499871
DOI: 10.1016/j.pathol.2017.09.026 -
Clinical Imaging Jan 2022To survey the occurrence rate of ascites in patients with thecoma-fibroma and its potential correlation with tumor MR imaging characteristics.
PURPOSE
To survey the occurrence rate of ascites in patients with thecoma-fibroma and its potential correlation with tumor MR imaging characteristics.
METHODS
A total of 40 patients with surgically proven thecoma-fibroma were enrolled in this retrospective study. We determined the tumor size, the components (solid or cystic) and their signal intensity features. Second, we identified ascites according to the fat-suppressed sagittal T-weighted imaging sequence and divided all cases into two groups (with or without ascites). Furthermore, we explored the correlations of ascites with tumor size, tumor solidity, pathological types, patient's postmenopausal status and serum CA-125 levels by using the χ test.
RESULTS
(1) Among the 40 cases, 15 tumors were fibromas, 15 thecomas, and 10 fibrothecomas. Nine patients (26.47%) had elevated CA-125 levels (>35.0 U/ml). (2) Thirty-one patients had ascites (77.50%), 29 of which had a small amount of ascites. Nine cases had no ascites (22.50%). (3) MRI showed a solid mass in 22 cases (55.0%), cystic mass in five cases (12.5%) and mixed solid-cystic mass in 13 cases (32.5%). The χ test revealed that the incidence of ascites was significantly correlated with tumor size, tumor solidity and serum CA-125 levels (P < 0.05), but not with menopause and pathological type (P > 0.05).
CONCLUSION
Our data revealed that the incidence of ascites was 77.50% and was mainly correlated with tumor size and elevated CA-125 levels. These findings have potential value for improving the diagnosis and differential diagnosis of thecoma-fibroma.
Topics: Female; Fibroma; Humans; Magnetic Resonance Imaging; Ovarian Neoplasms; Retrospective Studies; Thecoma
PubMed: 34607094
DOI: 10.1016/j.clinimag.2021.06.007 -
Gynecological Endocrinology : the... Sep 2020Hyperandrogenism is frequent and under investigated in adolescent girls. A 15-year-6-month-old French girl presented with oligomenorrhea and slowly progressing... (Review)
Review
Hyperandrogenism is frequent and under investigated in adolescent girls. A 15-year-6-month-old French girl presented with oligomenorrhea and slowly progressing virilization 2 years post-menarche. Medical history revealed prenatal pesticide exposure through maternal professional activity and recurrent premature thelarche. Severe hirsutism, mild facial acne and clitoromegaly were noted. Serum androgens (testosterone: 94 ng/dL, 4-androstenedione: 8.23 ng/mL) were high and non-classic 21-hydroxylase deficiency was excluded. Pelvic ultrasonography showed a left ovarian mass, confirmed by computed tomography scan. Tumor markers were negative. Laparoscopic surgery was performed. The pathological diagnosis was benign luteinized thecoma. Postoperatively, the menstrual cycle and serum androgens became normal and hirsutism slowly improved. Hyperandrogenism 2 years after menarche should be systematically investigated, even if slowly progressive, since it may be a symptom of a rare virilizing ovarian tumor, like thecoma.
Topics: Adolescent; Diagnosis, Differential; Disease Progression; Female; France; Humans; Hyperandrogenism; Ovarian Neoplasms; Testosterone; Thecoma; Ultrasonography; Virilism
PubMed: 32174224
DOI: 10.1080/09513590.2020.1739265 -
Acta Radiologica (Stockholm, Sweden :... May 2024Ovarian thecoma-fibroma and solid ovarian cancer have similar clinical and imaging features, and it is difficult for radiologists to differentiate them. Since the...
BACKGROUND
Ovarian thecoma-fibroma and solid ovarian cancer have similar clinical and imaging features, and it is difficult for radiologists to differentiate them. Since the treatment and prognosis of them are different, accurate characterization is crucial.
PURPOSE
To non-invasively differentiate ovarian thecoma-fibroma and solid ovarian cancer by convolutional neural network based on magnetic resonance imaging (MRI), and to provide the interpretability of the model.
MATERIAL AND METHODS
A total of 156 tumors, including 86 ovarian thecoma-fibroma and 70 solid ovarian cancer, were split into the training set, the validation set, and the test set according to the ratio of 8:1:1 by stratified random sampling. In this study, we used four different networks, two different weight modes, two different optimizers, and four different sizes of regions of interest (ROI) to test the model performance. This process was repeated 10 times to calculate the average performance of the test set. The gradient weighted class activation mapping (Grad-CAM) was used to explain how the model makes classification decisions by visual location map.
RESULTS
ResNet18, which had pre-trained weight, using Adam and one multiple ROI circumscribed rectangle, achieved best performance. The average accuracy, precision, recall, and AUC were 0.852, 0.828, 0.848, and 0.919 (< 0.01), respectively. Grad-CAM showed areas associated with classification appeared on the edge or interior of ovarian thecoma-fibroma and the interior of solid ovarian cancer.
CONCLUSION
This study shows that convolution neural network based on MRI can be helpful for radiologists in differentiating ovarian thecoma-fibroma and solid ovarian cancer.
PubMed: 38751048
DOI: 10.1177/02841851241252951 -
Abdominal Radiology (New York) Apr 2021Sex cord-stromal tumors of the ovary (SCST) are uncommon ovarian tumors arising from sex cord and/or stromal cells of the ovaries. They may be nonfunctional and... (Review)
Review
Sex cord-stromal tumors of the ovary (SCST) are uncommon ovarian tumors arising from sex cord and/or stromal cells of the ovaries. They may be nonfunctional and asymptomatic or functional presenting with hyperestrogenic, hyperandrogenic or cushingoid symptoms. They present in a wide age group of women, mostly in early stages and follow a nonaggressive clinical course after surgical resection. They differ from more prevalent epithelial ovarian tumors which tend to present in older women in advanced stages with poor prognosis. Some of SCSTs are associated with clinical syndromes. We will review imaging features on ultrasound, computed tomography and magnetic resonance imaging, epidemiology and clinical presentations of these tumors.
Topics: Aged; Female; Humans; Ovarian Neoplasms; Sex Cord-Gonadal Stromal Tumors
PubMed: 33725145
DOI: 10.1007/s00261-021-02998-w