Interactive Transcript
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Here's another case of a very large
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pelvic mass in a 47-year-old patient.
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She came to us for both ultrasound and CT.
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So in the ultrasound you can see
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a huge mass with multiple internal
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thin septations and multiple locules.
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And then on the CT.
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The locules are separated by thin
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septations that don't show much enhancement.
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There's no real nodular enhancement.
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But what's interesting is if you
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look at the composition of the
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locules, there's variable density.
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So this one here looks more like simple fluid.
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And then these two locules here
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have a bit more density to them.
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So potentially they may have some hemorrhage
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or some protein in it, or maybe some mucin.
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And this is a pretty characteristic
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appearance of a mucinous lesion.
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This one turned out to be a
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very large mucinous cystadenoma.
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So lots of locules with variable
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internal density or internal signal.
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And that's pretty typical
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for mucinous composition.
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So I want you to just try
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and remember this image.
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So remember the, the thin septations and
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the multiple loculations, the absence
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of really significant enhancement.
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There's maybe a bit of enhancement here,
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hard to tell, but really these multiple
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cystic spaces separated by thin septations.
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So this is obviously a very different situation.
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So this is a huge, very bizarre
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looking, heterogeneous, complex
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mass, and this is characteristic of
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an epithelial ovarian malignancy.
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So this would be, without
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a doubt, an ORADS 5 lesion.
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So big mass, the T2 signal is very heterogeneous
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with areas of high signal, intermediate signal,
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low signal, and then look at the enhancement.
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So there's nodular enhancement,
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solid enhancement, the septations
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look much thicker than we saw in the other case.
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So you can see how the complexity changes
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over that spectrum from benign to malignant.
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So that's an ORADS 5.
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