Clare Louise Bent MBBCh, Presenter: Nothing to Disclose

Anju Sahdev MBBS, Abstract Co-Author: Nothing to Disclose

Audrey Eleanor Therese Wenaden MBBS, Abstract Co-Author: Nothing to Disclose

Aslam Sohaib, Abstract Co-Author: Nothing to Disclose

Andrea Grace Rockall MBBS, Abstract Co-Author: Nothing to Disclose

Rodney Harris Reznek MD, Abstract Co-Author: Nothing to Disclose

Epithelial ovarian tumours are classified into benign, borderline and malignant. Histologically borderline tumours (10-20% of epithelial tumours) show no destructive stromal invasion, glandular confluence or stromal disappearance, may implant on peritoneal surfaces, but have a better prognosis than malignant ovarian tumours, greatly influencing treatment planning. We describe the MRI appearances of borderline tumours and specifically assess the frequency of benign appearance using previously described MR features to characterise lesions.

20 patients with 23 histologically confirmed borderline ovarian tumours were reviewed by 3 radiologists documenting the size of mass, number, regularity, contrast enhancement and maximum thickness of septa. Nodules or vegetations on the cyst wall or septa were noted. Ascites, peritoneal nodules and lymphadenopathy were sought.

23 tumours were diagnosed in 20 patients (age 19-86 years; mean 46 years). The maximum diameter of each mass ranged from 2-31 cm (mean 17 cm). 17/23 (74%) lesions were predominantly cystic in character (8 serous, 9 mucinous). 3/23 (13%) of the cystic lesions were unilocular. 5/23 (22%) were cystic with solid components (all serous). 1/23 (4%) was entirely solid (serous). 14/23 (61%) displayed thick walls >3 mm; 14/23 (61%) were irregular in contour; and 16/23 (70%) had associated nodules. 14/23 (61%) of the lesions had >5 septa; 2/23 (9%) had between 2 and 5 septa; 3/23 (13%) lesions had a single septum. Thickened septa (>3 mm thickness) were seen in 14/23 (61%). 14/23 (61%) had irregular septa and 12/23 (52%) had septal nodules. Ascites was identified in 6/23 (26%) patients. 2/23 (9%) patients demonstrated evidence of lymphadenopathy. Features consistent with malignancy were identified in all 23 tumours.

This large study shows that all borderline tumours displayed features on MRI indicative of malignancy. 8 patients had supporting evidence of malignancy with ascites and lymphadenopathy. No borderline tumours had benign appearances.

Epithelial ovarian tumours are classified into benign, borderline and malignant. Histologically borderline tumours (10-20% of epithelial tumours) show no destructive stromal invasion, glandular confluence or stromal disappearance, may implant on peritoneal surfaces, but have a better prognosis than malignant ovarian tumours, greatly influencing treatment planning. We describe the MRI appearances of borderline tumours and specifically assess the frequency of benign appearance using previously described MR features to characterise lesions.

20 patients with 23 histologically confirmed borderline ovarian tumours were reviewed by 3 radiologists documenting the size of mass, number, regularity, contrast enhancement and maximum thickness of septa. Nodules or vegetations on the cyst wall or septa were noted. Ascites, peritoneal nodules and lymphadenopathy were sought.

23 tumours were diagnosed in 20 patients (age 19-86 years; mean 46 years). The maximum diameter of each mass ranged from 2-31 cm (mean 17 cm). 17/23 (74%) lesions were predominantly cystic in character (8 serous, 9 mucinous). 3/23 (13%) of the cystic lesions were unilocular. 5/23 (22%) were cystic with solid components (all serous). 1/23 (4%) was entirely solid (serous). 14/23 (61%) displayed thick walls >3 mm; 14/23 (61%) were irregular in contour; and 16/23 (70%) had associated nodules. 14/23 (61%) of the lesions had >5 septa; 2/23 (9%) had between 2 and 5 septa; 3/23 (13%) lesions had a single septum. Thickened septa (>3 mm thickness) were seen in 14/23 (61%). 14/23 (61%) had irregular septa and 12/23 (52%) had septal nodules. Ascites was identified in 6/23 (26%) patients. 2/23 (9%) patients demonstrated evidence of lymphadenopathy. Features consistent with malignancy were identified in all 23 tumours.

This large study shows that all borderline tumours displayed features on MRI indicative of malignancy. 8 patients had supporting evidence of malignancy with ascites and lymphadenopathy. No borderline tumours had benign appearances.

Bent, C, Sahdev, A, Wenaden, A, Sohaib, A, Rockall, A, Reznek, R, MRI Appearances of Borderline Ovarian Carcinoma.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4416481.html