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Enea M, Khoshpouri P, Goncalves Filho ALDM, Zaki-Metias KM, Rouzrokh P. Ovarian Fibromatosis. Radiographics 2024; 44:e240044. [PMID: 39052502 DOI: 10.1148/rg.240044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Affiliation(s)
- Michael Enea
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141 (M.E.); Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (P.K.); Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada (A.L.d.M.G.F.); Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Department of Radiology, Mayo Clinic, Rochester, Minn (P.R.)
| | - Parisa Khoshpouri
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141 (M.E.); Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (P.K.); Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada (A.L.d.M.G.F.); Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Department of Radiology, Mayo Clinic, Rochester, Minn (P.R.)
| | - Augusto Lio da Mota Goncalves Filho
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141 (M.E.); Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (P.K.); Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada (A.L.d.M.G.F.); Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Department of Radiology, Mayo Clinic, Rochester, Minn (P.R.)
| | - Kaitlin M Zaki-Metias
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141 (M.E.); Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (P.K.); Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada (A.L.d.M.G.F.); Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Department of Radiology, Mayo Clinic, Rochester, Minn (P.R.)
| | - Pouria Rouzrokh
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141 (M.E.); Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colo (P.K.); Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada (A.L.d.M.G.F.); Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Department of Radiology, Mayo Clinic, Rochester, Minn (P.R.)
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Takeda A, Watanabe K, Koike W. Ovarian fibromatosis associated with large pedunculated fibroma in a 30-year-old woman: A rare coincidence or variant? J Obstet Gynaecol Res 2024; 50:270-274. [PMID: 37968569 DOI: 10.1111/jog.15830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023]
Abstract
A 30-year-old nulligravida was referred under suspicion of large subserosal myoma. T2-weighted magnetic resonance imaging revealed multilobulated solid mass in the left lower abdomen measuring 16 cm in longitudinal diameter. The ovarian surface was covered with a marked T2-hypointense thick rim called "black garland sign," forming multiple nodular masses ranging from 1 to 5 cm in diameter in some portions of the bilateral ovaries. By laparoscopic-assisted minilaparotomy, the stalk of pedunculated mass originating from the left ovarian hilum was excised, followed by carrying out of the body after in-bag morcellation using a surgical scalpel. Right ovarian exophytic nodular masses larger than 1 cm were excised using monopolar electrode needle. Pathological examination of excised right and left masses showed fibroblast-like spindle cell proliferation with collagenous stroma; however, differences between right and left masses cannot be distinguished on a histological level. Postoperative diagnosis was ovarian fibromatosis coexisting with large pedunculated fibroma.
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Affiliation(s)
- Akihiro Takeda
- Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
| | - Kazuko Watanabe
- Department of Diagnostic Pathology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
| | - Wataru Koike
- Department of Diagnostic Radiology, Gifu Prefectural Tajimi Hospital, Gifu, Japan
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Urios MS, García Espasa C, Concepción Aramendía L. Ovarian Fibromatosis: "The black garland sign". RADIOLOGIA 2021; 64:S0033-8338(21)00015-1. [PMID: 33551120 DOI: 10.1016/j.rx.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 11/22/2022]
Abstract
The main objective in the imaging differential diagnosis of an ovarian mass is to establish whether it is cystic or solid; solid lesions are less common. Ovarian fibromatosis is a benign disease of the ovary that is rarely included in the differential diagnosis of solid ovarian lesions. Characteristic features of masses that have a fibrous component are low signal in T1-weighted MRI sequences and especially in T2-weighted MRI sequences. The presence of peripheral fibrotic tissue around the residual ovarian tissue is specific to ovarian fibromatosis; on MRI, this results in marked hypointensity on T2-weighted images that has been dubbed the "black garland sign". This sign, together with slight peripheral enhancement after the administration of contrast material and the preservation of the ovarian architecture, facilitates the diagnosis, making it possible to avoid unnecessary surgical interventions.
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Affiliation(s)
- M Santos Urios
- Servicio de Radiodiagnóstico, Hospital General Universitario de Alicante, Alicante, España.
| | - C García Espasa
- Servicio de Radiodiagnóstico, Hospital General Universitario de Alicante, Alicante, España
| | - L Concepción Aramendía
- Servicio de Radiodiagnóstico, Hospital General Universitario de Alicante, Alicante, España
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Ovarian solid tumors: MR imaging features with radiologic-pathologic correlation. Jpn J Radiol 2020; 38:719-730. [PMID: 32342277 DOI: 10.1007/s11604-020-00976-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
Ovarian solid tumors have variable histological types including benign and malignant tumors. In addition, non-neoplastic lesions sometimes show a tumor-like appearance. It is important to differentiate benign from malignant tumors. In general, low signal intensity (SI) on T2-weighted imaging (T2WI), low SI on diffusion-weighted imaging (DWI), and gradual increased pattern on dynamic contrast-enhanced magnetic resonance (MR) imaging are known to be suggestive of a benign tumor. Conversely, there are some cases in which these rules do not apply. We should, therefore, strive for a greater understanding of these exceptional cases. Several tumors show characteristic findings on MR imaging reflecting pathologic features, which leads to the correct diagnosis. Additionally, MR imaging provides important information other than the nature of tumors, such as secondary uterine changes. Furthermore, clinical findings and laboratory examination data also help in determining the correct diagnosis.
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Montoriol PF, Bayol B. Ovarian fibromatosis: The "black garland" sign. Diagn Interv Imaging 2019; 101:259-260. [PMID: 31711935 DOI: 10.1016/j.diii.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Affiliation(s)
- P-F Montoriol
- Department of Radiology, Centre Jean Perrin, 63000 Clermont-Ferrand, France.
| | - B Bayol
- Department of Pathology, Centre Jean Perrin, 63000 Clermont-Ferrand, France
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Lalwani N, Patel S, Ha KY, Shanbhogue AK, Nagar AM, Chintapalli KN, Prasad SR. Miscellaneous tumour-like lesions of the ovary: cross-sectional imaging review. Br J Radiol 2012; 85:477-86. [PMID: 22253351 DOI: 10.1259/bjr/92819127] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Miscellaneous tumour-like ovarian lesions are histobiologically diverse, and are often mistaken for the more common ovarian cancers, leading to aggressive management. Knowledge of characteristic clinical, laboratory and imaging findings of these select non-neoplastic ovarian entities allows correct diagnoses and permits optimal management.
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Affiliation(s)
- N Lalwani
- Department of Radiology, University of Texas Health Science Center, San Antonio, USA
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