I saw the “sea anemone” sign: Puffy face of borderline ovarian tumors

Abstract

The sea anemone sign is a radiologic sign seen on magnetic resonance imaging (MRI) studies that indicates the morphological development of serous borderline ovarian tumors (SBOTs), as papillary projections originating from the wall of the cystic lesion. The presence of T2 hypointense fibrous stroma in the center of the papilla is a helpful tip in the diagnosis of SBOTs. Those projections might also be assumed to have a frond-like appearance which can be seen as branching papillary projections, especially on T2-weighted imaging.The term “sea anemone” sign is described by Tanaka et al. who deemed it as a “hallmark” feature of surface SBOTs.