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Ovarian Tumor – Case

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Okay, so here we have a case of an

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enormous cystic mass in this woman.

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She's perimenopausal.

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You can see that the uterus has been displaced

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anteriorly, and it's kind of compressed.

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The bladder is this thin black line here.

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So this is another case.

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Okay.

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The reason that we ask our patients to

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empty their bladder prior to the scan,

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if we know that we're imaging a mass, it

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makes it more, well, more comfortable or as

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comfortable as it can be for these patients.

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If they have a full bladder, then it makes it

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really difficult to stay still for the scan.

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So this enormous mass is what

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we're evaluating in this study.

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So you can see on the

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T2-weighted images here,

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it's fairly homogeneous, so it doesn't

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really have any septations within it.

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It's composed of primarily just

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simple high T2 signal fluid.

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And then on the post-contrast T1

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weighted images here, you can see

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that the fluid again is simple.

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There's no proteinaceous component

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and no hemorrhagic component.

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But what's interesting is we've got these

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very irregular-looking two focal areas.

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They almost look like, you know, flowers

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or what a bladder calculus would look

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like, but they're kind of multiflocculated

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stellate structures that are low T2 signal.

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They do enhance.

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So this is what that black sponge

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appearance looks like, where you've got

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the below T2 signal and entrapped or

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punctate areas of high T2 signal within it.

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And that's pretty typical

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of a cystadenofibroma.

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And what can be a little bit confusing

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and alarming is that these lesions, uh,

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the solid component rather enhances.

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So even though these are benign,

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they do have some features which

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are concerning for malignancy.

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And regardless of whether this is benign

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or malignant, this needs to come out.

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So just first of all, just based on

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the size, and then secondly, because of

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these peripheral enhancing components.

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So this is a really nice example of a

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cystadenofibroma with the black sponge.

Report

Faculty

Zahra Kassam, MD, FRCPC

Associate Professor of Medical Imaging, Division Head of Body Imaging

Western University

Tags

Ovaries

Neoplastic

MRI

Gynecologic (GYN)

Body

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