MyPACS.net: Radiology Teaching Files > Case 51306417

Last visited 06-09-2011 OVARIAN MASS
Contributed by: Tiguidanke Bah, Sonographer, Triton College, River Grove, IL, USA, Illinois, USA.
Patient: 68 year old female
History:

68 years old female with bleeding and left ovarian enlargement is seen for a pelvic exam fallow up. She had a Pelvic ULS done 2 wks prior.  

LMP 19 years ago, G4P4AB0 

Images:[small]larger

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Fig. 7

Fig. 8

Fig. 9

Fig. 10

Fig. 11

Fig. 12

Fig. 13

Fig. 14

Fig. 15
Findings:

Both  Transabdominal, and Endovaginal studies were performed and the following findings were obtained:

 The uterus is retroverted and measures 8.6cm in it longest axis, 4.0cm in AP, and 6.4cm in transverse. The endometrium appears normal in echogenicity, and measures 0.4cm in its maximum thickness. There is a small  hypoechoic nodule that is compatible with a leiomyoma in the left posterolateral region of the fundus measuring 1.2 x 0.9 x1.2 cm.

 Both ovaries are well visualized. The right ovary measures 1.0 x2.1 x1.4 cm; the left ovary remains enlarged and irregular in contour and measures 3.4 x1.9 x 2.6 cm and appears heterogenously hypoechoic. There is an exophytic nodule extending from the superior and medial aspect of the left ovary measuring 1.8 x 1.0 x1.2 cm. This nodule is homogeneous, hypoechoic with uniform vascularity an is located immedialely lateral to the uterine fundus in the regioin of the periuterine venous plexus. This nodule does not have the USA of a fluid structure

  

Diagnosis:

A Biopsy was performed, and  the final diagnosis was confirmed with a High grade Serous Papillary carcinoma of the left ovary and Follopian tube.

 

Discussion:

Serous Pappillary Carcinoma of the ovary

- Rare, and lethal malignant tumor of the ovary

- Consist of Epithelial tissue

 - May be associated with mutations in breast Cancer

- Has high incidence in pre- or post- menopausal of low parity

- Very agressive, it has a high potential to invade the fallopian tube, the uterus, and peritonel cavity

- It can be unilateral or bilateral

- Predominantely Cystic/solid

-The more solid and vascular the mass is, the greater its potential for malignancy

CARCINOMA OF THE FALLOPIAN TUBE:

- Very, very rare

- Less than 1% incidence of all gynecologic malignancies

- Occurs in postmenopausal wommen

- Adenocarcinoma is the most common

- USA: Sausage-shape complex mass often with papillary projections.

 

References:

- Charlotte Henningsen, Clinical Guide to Ultrasonography

- Hagen-Ansert, Sandra Textbook of Diagnostic Sonography, Vol 2, 6th edition   

- http//www.nature.com/modpathol/journal/v20/n8/full/3800827a.html

Comments:
No comments posted.
Additional Details:

Case Number: 51306417Last Updated: 06-09-2011
Anatomy: Genitourinary (GU)   Pathology: Neoplasm
Modality: USAccess Level: Readable by all users

The reader is fully responsible for confirming the accuracy of this content.
Text and images may be copyrighted by the case author or institution.
You can help keep MyPACS tidy: if you notice a case which is not useful (e.g. a test case) or inaccurate, please contact us.