CT imaging of ovarian yolk sac tumor with emphasis on differential diagnosis.

Yang-Kang Li,Guo-Jun Zhang,Xiu-Guo Zhou,Gui-Xiao Xu,Ai-Qun Cai,Yu Zheng,Jian-Bang Lin

doi:10.1038/srep11000

Abstract

Ovarian yolk sac tumors (YSTs) are rare neoplasms. No radiological study has been done to compare the imaging findings between this type of tumor and other ovarian tumors. Here we analyzed the CT findings of 11 pathologically proven ovarian YSTs and compared their imaging findings with 18 other types of ovarian tumors in the same age range. Patient age, tumor size, tumor shape, ascites and metastasis of two groups did not differ significantly (P > 0.05). A mixed solid-cystic nature, intratumoral hemorrhage, marked enhancement and dilated intratumoral vessel of two groups differed significantly (P < 0.05). The area under the ROC curve of four significant CT features was 0.679, 0.707, 0.705, and 1.000, respectively. Multivariate logistic regression analysis identified two independent signs of YST: intratumoral hemorrhage and marked enhancement. Our results show that certain suggestive CT signs that may be valuable for improving the accuracy of imaging diagnosis of YST and may be helpful in distinguishing YST from other ovarian tumors.

Highlights

Bilateral ovarian cystadenocarcinomas were detected in 2 patients, and a total of 18 tumors were evaluated in the non-Yolk sac tumor (YST) group, including 3 dysgerminoma, 2 immature teratomas, 9 serous or mucinous cystadenocarcinomas, 1 borderline serous cystadenoma, 1 struma ovarii, 1 Sertoli-Leydig cell tumor (SLCT) and 1 sclerosing stromal tumor (SST)
Bilateral ovarian YSTs were detected in one patient
This article is the largest study of ovarian YST in the radiological literatures

Summary

Introduction

The density of the tumor parenchyma with marked enhancement was similar to that of vessels on post-contrast images, and “bright dot” sign might be overlooked in these areas. Heterogeneous marked enhancement of the tumor and enlarged intratumoral vessels are detected (black arrow). A A solid cystic mass with heterogeneous moderate to marked enhancement in the left pelvic cavity (black arrow).

Results

Conclusion