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Taha T, Abu-Sini H, Billan S. Tyrosine kinase inhibitor treatment and long-term follow-up for metastatic malignant struma ovarii. Pediatr Hematol Oncol 2022; 39:769-775. [PMID: 35502916 DOI: 10.1080/08880018.2022.2064021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Metastatic malignant struma ovarii (MMSO) is a very rare disease (in the United States, less than one case in 10 million females annually). However, this incidence rate is due to a paucity of data regarding diagnosis, treatment, and follow-up. Herein, we describe the case of a 14-year-old female who presented with MMSO, which later metastasized and was followed up on for over 10 years. The patient underwent right oophorectomy surgery and was then treated with a combination of radioactive iodine followed by iodine scans to detect the absorption of radioiodine in the metastatic sites, and radiation therapy to treat skeletal lesions. She subsequently received treatment with the tyrosine kinase inhibitors (TKIs), sorafenib and then lenvatinib, as treatments for advanced disease, thereby achieving long-term disease stability. This case report, which adds to the limited data available on MMSO treatment, suggests that patients treated with a combination of radioactive iodine, radiation therapy, and TKIs can result in good responses and long-term overall survival.
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Affiliation(s)
- Tarek Taha
- Oncology Institute, Technion Faculty of Medicine, Rambam Health Care Campus, Haifa, Israel.,Oncology Institute, Baruch Padeh Medical Center, Poriya, Galilee, Israel
| | - Hosam Abu-Sini
- Oncology Institute, Technion Faculty of Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Salem Billan
- Oncology Institute, Technion Faculty of Medicine, Rambam Health Care Campus, Haifa, Israel.,The Holy Family Hospital, HaGalil Corner, Nazareth, Israel
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2
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Rockson O, Kora C, Ramdani A, Basma A, Bouhout T, Serji B, El Harroudi T. Struma ovarii: two case reports of a rare teratoma of the ovary. J Surg Case Rep 2020; 2020:rjaa493. [PMID: 33343869 PMCID: PMC7737006 DOI: 10.1093/jscr/rjaa493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/29/2020] [Accepted: 10/31/2020] [Indexed: 11/15/2022] Open
Abstract
Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. It is usually a benign condition; however, malignant transformation is sometimes detected. The diagnosis relies on histopathological examination and is infrequently made on routine investigations. We report two cases of struma ovarii: one benign and the other malignant. The first case involved a 27-year-old woman who underwent a right ovarian cystectomy for an incidental ultrasonographic finding of a solid right adnexal mass. The diagnosis of a benign struma was made after histopathological study. The second case involved a 68-year-old woman who underwent a right salpingo-oophorectomy for a right ovarian bulky mass and the histopathological diagnosis was consistent with that of a malignant struma. We examine the challenges involved in the diagnosis and management of this rare entity.
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Affiliation(s)
- Obed Rockson
- Department of Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, Morocco
| | - Christine Kora
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
| | - Abdelbassir Ramdani
- Department of Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, Morocco
| | - Aabdi Basma
- Department of Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, Morocco
| | - Tariq Bouhout
- Department of Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, Morocco
| | - Badr Serji
- Department of Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, Morocco
| | - Tijani El Harroudi
- Department of Surgical Oncology, Mohammed VI University Hospital, Regional Oncology Center, Oujda, Morocco
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Koual M, Nguyen-Xuan HT, Deidier J, Le Frère-Belda MA, Bats AS. [Struma ovarii: A rare ovarian tumor to know]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:837-839. [PMID: 32470557 DOI: 10.1016/j.gofs.2020.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Meriem Koual
- Faculté de médecine Paris Descartes, université de Paris, Paris, France; AP-HP, Centre, hôpital Européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, Paris, France; Inserm UMR-S 1124, université de Paris, centre universitaire des Saints-Pères, Paris, France.
| | - Huyen-Thu Nguyen-Xuan
- Faculté de médecine Paris Descartes, université de Paris, Paris, France; AP-HP, Centre, hôpital Européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, Paris, France
| | - Jonas Deidier
- Faculté de médecine Paris Descartes, université de Paris, Paris, France; AP-HP, Centre, hôpital Européen Georges-Pompidou, radiologie, Paris, France
| | | | - Anne-Sophie Bats
- Faculté de médecine Paris Descartes, université de Paris, Paris, France; AP-HP, Centre, hôpital Européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, Paris, France; Inserm UMR-S 1147, université de Paris, centre universitaire des Saints-Pères, Paris, France
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4
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Peritoneal strumosis: Presentation and management with multiple radioactive iodine treatments. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2018. [DOI: 10.1016/j.jecr.2018.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Oporto M, Orta N, Cepa F, Pons M, Cabrer M, Peña C. Captación de yoduro sódico 131 I en un teratoma ovárico. Rev Esp Med Nucl Imagen Mol 2018; 37:50-51. [DOI: 10.1016/j.remn.2017.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/20/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
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6
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Radioactive sodium iodide 131 I uptake in an ovarian teratoma. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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7
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Raiteb H, El Fazazi H, Kouach J, Moussaoui D, Dehayni M. [Struma ovarii: a rare case of giant ovarian cyst]. Pan Afr Med J 2017; 26:223. [PMID: 28690737 PMCID: PMC5491739 DOI: 10.11604/pamj.2017.26.223.10621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/02/2016] [Indexed: 11/30/2022] Open
Abstract
Le struma ovarii est une tumeur rare qui représente 2,7% des tératomes ovariens et 0,01% des tumeurs ovariennes. Elle survient souvent chez la femme au cours de la cinquième décennie et constitue le plus souvent une surprise de l'examen échographique puis histologique. Sa prise en charge est chirurgicale et son pronostic est excellent. Nous rapportons un cas particulier de struma ovarii, vu sa survenue chez une femme jeune, la taille importante de la tumeur et sa présentation radiologique inhabituelle. Nous confrontons ce cas aux données de la littérature.
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Affiliation(s)
- Hanane Raiteb
- Service de Gynéco-Obstétrique, Hôpital Militaire d'Instruction Mohammed V Rabat, Maroc
| | - Hicham El Fazazi
- Service de Gynéco-Obstétrique, Hôpital Militaire d'Instruction Mohammed V Rabat, Maroc
| | - Jaouad Kouach
- Faculté de Médecine et de Pharmacie, Université Mohammed V Souissi, Rabat Maroc
| | - Driss Moussaoui
- Faculté de Médecine et de Pharmacie, Université Mohammed V Souissi, Rabat Maroc
| | - Mohamed Dehayni
- Faculté de Médecine et de Pharmacie, Université Mohammed V Souissi, Rabat Maroc
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Treatment and follow-up of malignant struma ovarii: Regarding two cases. Gynecol Oncol Rep 2016; 17:56-9. [PMID: 27355004 PMCID: PMC4913172 DOI: 10.1016/j.gore.2016.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/19/2016] [Accepted: 05/31/2016] [Indexed: 02/02/2023] Open
Abstract
Malignant struma ovarii (SO) is a rare tumor, and as a consequence, treatments and follow-up procedures are not clearly established. Presented in this study are two cases of suspicious ovarian masses, resected and corresponding to malignant SO on histopathology. Similar to thyroid cancer, we proposed complementary radioiodine therapy (131I) after total thyroidectomy (no malignancy was observed at this level in our two patients). Patients underwent treatment with 3.7 GBq 131I followed by post-therapy whole-body scintigraphy, which can detect residual disease or occult metastases. Thyroid remnant ablation increases the sensitivity and specificity of follow-up testing using serum thyroglobulin levels as a tumor marker. Our two patients remained disease-free for 3 and 5 years, respectively, after treatment. Malignant struma ovarii is a rare ovarian tumor, corresponding to thyroid carcinoma. It is generally diagnosed after surgical resection of an ovarian mass. Iodine 131 therapy can be proposed for adjuvant therapy, after total thyroidectomy. Follow-up must be extended for 20 years, using thyroglobulin level as a tumor marker.
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Lamblin G, Gallice C, Bournaud C, Nadaud B, Lebail-Carval K, Chene G. [Benign struma ovarii: Report of 7 cases and review of the literature]. ACTA ACUST UNITED AC 2016; 44:263-8. [PMID: 26997461 DOI: 10.1016/j.gyobfe.2016.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/04/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Struma ovarii is a monodermal teratoma composed of thyroid tissue, representing 0.85 to 1.3% of ovarian tumors. The objective of the present study is to report a continuous series of struma ovarii, with a comprehensive analysis of the literature. METHODS A retrospective study in the gynecological surgery department of Hôpital Femme-Mère-Enfant (Hospices Civils de Lyon, Lyon, France) assessed a continuous series of struma ovarii from the Lyon East Pathology Center database. Clinical and biological, imaging and pathological aspects were analyzed and the various forms of treatment described. RESULTS We identified 7 patients with struma ovarii from March 2008 to April 2015. Mean patient age was 49.7 years (28-70years). Three patients had a history of thyroid disease. CA-125 was elevated (51IU/mL) in only 1 patient. MRI and ultrasound imaging did not enable diagnosis of struma ovarii, which depended on pathologic examination. Conservative surgery for cystectomy or oophorectomy was performed for patients wishing to become pregnant (71%); nonconservative hysterectomy was performed in postmenopausal women (29%). CONCLUSIONS Struma ovarii is a rare, often asymptomatic condition in which diagnosis is difficult. Few series are described in the literature. Here we propose a management model for struma ovarii. Revision surgery and adjuvant therapy is indicated in case of malignant struma ovarii.
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Affiliation(s)
- G Lamblin
- Service de chirurgie gynécologique, université Claude Bernard-Lyon 1, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Lyon-Bron, France.
| | - C Gallice
- Service de chirurgie gynécologique, université Claude Bernard-Lyon 1, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - C Bournaud
- Service de médecine nucléaire, groupement hospitalier Est, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - B Nadaud
- Service de pathologie Est (CPE), groupement hospitalier Est, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - K Lebail-Carval
- Service de chirurgie gynécologique, université Claude Bernard-Lyon 1, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - G Chene
- Service de chirurgie gynécologique, université Claude Bernard-Lyon 1, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Lyon-Bron, France
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Razafimanjato NNM, Rakotonaivo MJ, Hunald FA, Samison LH, Rakotovao HJL, Rakototiana AF. [Pseudosyndrome of Meigs revealer of an ovarian goiter]. ACTA ACUST UNITED AC 2014; 42:810-2. [PMID: 25444703 DOI: 10.1016/j.gyobfe.2014.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 09/03/2014] [Indexed: 11/29/2022]
Abstract
The pseudosyndrome of Meigs is caracterised by a triad, which associates a solid benign tumor of the ovary, an ascitis and a pleural effusion. Surgical extraction of the tumor entails disappearance of the symptomatology. The authors report in this study a case of an ovarian goitre revealed by this syndrom.
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Affiliation(s)
- N N M Razafimanjato
- Service de chirurgie thoracique CHU/JRA, 4150 CP, 101, Antananarivo, Madagascar.
| | - M J Rakotonaivo
- Service de chirurgie viscérale CHU/JRA, 4150 CP, 101, Antananarivo, Madagascar
| | - F A Hunald
- Service d'urologie CHU/JRA, 4150 CP, 101, Antananarivo, Madagascar
| | - L H Samison
- Service de chirurgie viscérale CHU/JRA, 4150 CP, 101, Antananarivo, Madagascar
| | - H J L Rakotovao
- Service de chirurgie thoracique CHU/JRA, 4150 CP, 101, Antananarivo, Madagascar
| | - A F Rakototiana
- Service d'urologie CHU/JRA, 4150 CP, 101, Antananarivo, Madagascar
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Chabrol A, Rousset P, Charlot M, Chateau F, Cotton F, Golfier F, Rety F. Lesions of the ovary with T1-hypersignal. Clin Radiol 2014; 69:e404-13. [PMID: 25017450 DOI: 10.1016/j.crad.2014.05.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/08/2014] [Accepted: 05/23/2014] [Indexed: 11/28/2022]
Abstract
Pelvic magnetic resonance imaging (MRI) has been used successfully to diagnose ovarian masses that cannot be adequately evaluated using pelvic ultrasound. T1 hyperintensity is a common finding in an ovarian mass and has important diagnostic implications. The aims of this review are to list the substances that may produce high signal intensity on T1-weighted MRI, to explain the physical basis for causes of the high T1 signal intensity, and to describe common and uncommon T1 hyperintense ovarian lesions. The morphological findings, the imaging features of the additional sequences, and clinical variables can help in the differential diagnosis, and in some cases, enable a specific diagnosis, leading to appropriate management of the patient.
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Affiliation(s)
- A Chabrol
- Department of Radiology, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France.
| | - P Rousset
- Department of Radiology, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France
| | - M Charlot
- Department of Radiology, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France
| | - F Chateau
- Department of Radiology, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France
| | - F Cotton
- Department of Radiology, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France
| | - F Golfier
- Department of Gynaecological and Oncological Surgery-Obstetrics, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France
| | - F Rety
- Department of Radiology, Centre Hospitalier Lyon Sud, chemin du grand revoyet, 69310 Pierre Bénite, France
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12
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Peyron N, Coulon A. Struma ovarii, pseudo-Meigs' syndrome and raised CA125, a rare association. Answer to May e-quid. Diagn Interv Imaging 2012; 93:643-7. [PMID: 22818078 DOI: 10.1016/j.diii.2012.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- N Peyron
- Service d'imagerie médicale, hospices civils de Lyon, hôpital de la Croix-Rousse, Lyon, France.
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13
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Miñambres I, Vinagre I, Corcoy R, de Leiva A, Pérez A. Unusual characteristics and fatal outcome of a malignant struma ovarii. Case report and literature review. ACTA ACUST UNITED AC 2011; 58:377-9. [PMID: 21531638 DOI: 10.1016/j.endonu.2011.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Revised: 02/14/2011] [Accepted: 02/15/2011] [Indexed: 11/30/2022]
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15
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Ostör G, Tóth I, Hrubyné Tóth Z, Bazsa S. [Cystic struma ovarii, a rare form of ovarian tumor--case report, and review of the literature]. Orv Hetil 2007; 148:2285-7. [PMID: 18039620 DOI: 10.1556/oh.2007.28202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Struma ovarii represents less than 3% of ovarian teratomas. It can be associated with thyroid biology abnormalities, and in exceptionally rare cases it can be malignant. The authors report a case of a 31-year-old woman who underwent resection of a left ovarian cyst, presenting with the clinical features of an ovarian cancer (large pelvic mass, ascites and elevated CA-125 serum levels). The pathologic diagnosis was benign struma ovarii. The postoperative thyroid function remained normal.
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Kalish GM, Patel MD, Gunn MLD, Dubinsky TJ. Computed Tomographic and Magnetic Resonance Features of Gynecologic Abnormalities in Women Presenting With Acute or Chronic Abdominal Pain. Ultrasound Q 2007; 23:167-75. [PMID: 17805165 DOI: 10.1097/ruq.0b013e31815202df] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Advances in technology and improved availability have led to increased use of computed tomography (CT) and magnetic resonance imaging (MRI) to evaluate women presenting to the emergency department or to their primary care provider with abdominal and/or pelvic pain. Computed tomographic examinations are often performed to evaluate the presence of appendicitis or renal stone disease. However, gynecologic abnormalities are frequently identified on these examinations. Although ultrasound remains the primary modality by which complaints specific to the pelvis are evaluated, in many instances, CT and MRI imaging occurs before sonographic evaluation.Historically, because of cost, radiation exposure, and relative ease of use, ultrasound examinations have preceded all other imaging modalities when evaluating pelvic disorders. However, as CT and MRI technology have improved, their use in diagnosing causes of pelvic pain has become equal to that of ultrasound. In some cases, primarily because of historic comfort with sonographic evaluation, gynecologic abnormalities originally diagnosed on CT or MRI may be immediately and unnecessarily reevaluated by ultrasound. For a woman in her reproductive years, the most common adnexal masses are physiological cysts, endometriomas, and cystic teratomas. Although lesions are often asymptomatic and incidentally detected, they can present with pain, and they increase the risk of ovarian torsion. Common causes of chronic pelvic pain in this population include leiomyomata and adenomyosis. In postmenopausal women, ovarian carcinoma, which often does not present clinically until a late stage, has to be included in the differential diagnosis of adnexal masses. If a gynecologic pathology is discovered on CT or MRI, an immediate follow-up ultrasound need not be pursued if the lesion can be characterized as benign, needing immediate surgical intervention, or a variant of normal anatomy. If, on the other hand, findings demonstrate a mass that either is uncharacteristic of a benign lesion, has an indeterminate risk for malignancy, or demonstrates suspicious characteristics for malignancy (such as enhancing mural nodules), further evaluation by serial ultrasound, biochemical marker, and/or CT or MRI is warranted. The purpose of this review is to present a series of commonly encountered gynecologic abnormalities with either CT or MR to make radiologists more familiar with gynecologic pathology on CT and MRI.
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Affiliation(s)
- Grace M Kalish
- Department of Radiology, University of Washington School of Medicine, Seattle, WA 98104-2499, USA
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