Korean J Radiol.  2007 Apr;8(2):120-126. 10.3348/kjr.2007.8.2.120.

Variable CT Findings of Epithelial Origin Ovarian Carcinoma According to the Degree of Histologic Differentiation

• Jang YJ
• Kim JK
• Park SB
• Cho KS

• KMID: 1126835
• DOI: http://doi.org/10.3348/kjr.2007.8.2.120

Abstract

OBJECTIVE
We wanted to evaluate the CT findings of epithelial origin ovarian carcinoma according to the degree of histologic differentiation. MATERIALS AND METHODS: This study enrolled 124 patients with 31 well differentiated, 44 moderately differentiated and 95 poorly differentiated carcinomas with epithelial origin. The CT images were retrospectively evaluated with regard to bilateral ovarian involvement, the tumor's nature, lymphadenopathy, adjacent organ invasion, peritoneal tumor seeding, a large amount of ascites and distant metastasis. In cystic, predominantly cystic and mixed tumors, the tumor wall, septa, papillary projection and necrosis in the solid portion were assessed. RESULTS: Bilateral ovarian involvement was more common in the poorly (48%) and moderately (42%) differentiated carcinomas than in the well differentiated carcinomas (7%) (p < 0.05). The frequency of a predominantly solid or solid nature was greater in the moderately and poorly differentiated carcinomas than in the well differentiated carcinomas (p < 0.0001). In the 87 tumors with a cystic, predominantly cystic or mixed nature, septa greater than 3 mm, papillary projection and necrosis in the solid portion were more common in the poorly differentiated carcinoma (91%, 91% and 77%, respectively) than in the moderately (64%, 68% and 34%, respectively) and well differentiated carcinomas (63%, 47% and 27%, respectively) (p < 0.05). Lymphadenopathy, organ invasion, tumor seeding and a large amount of ascites were more common in the poorly differentiated carcinomas (38%, 27%, 73% and 69%, respectively) than in the moderately (13%, 10%, 48% and 45%, respectively) and well differentiated carcinomas (3%, 0%, 10% and 17%, respectively) (p < 0.05). CONCLUSION: Epithelial origin ovarian carcinoma shows different CT findings according to the degree of histologic differentiation.

Keyword

Ovarian cancer, differentiation; Computed tomography (CT)

MeSH Terms

Ascites/radiography
Carcinoma/*pathology/*radiography
Contrast Media
Female
Humans
Iohexol/analogs & derivatives
Iopamidol
Lymphatic Metastasis
Middle Aged
Neoplasm Invasiveness
Ovarian Neoplasms/*pathology/*radiography
Retrospective Studies
Tomography, Spiral Computed/*methods

Figure

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  Fig. 1 30-year-old female patient with well differentiated ovarian carcinoma. Transverse CT image shows 12-cm-sized unilocular cystic mass (arrows). Mass originates from the right ovary and the left ovary (not shown) is normal.

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  Fig. 2 46-year-old female patient with poorly differentiated ovarian carcinoma. Transverse CT image shows two masses involving bilateral ovaries (arrows). Both masses show solid nature.

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  Fig. 3 50-year-old female with moderately differentiated ovarian carcinoma. Tansverse CT image shows cystic mass from the left ovary (arrows), which shows septa thinner than 3 mm in diameter (arrowheads) but no papillary projection or necrosis in the solid protion.

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  Fig. 4 53-year-old female patient with pooly differentiated ovarian carcinoma. Transverse CT image shows mass with mixed pattern (arrows). Mass shows necrosis in the solid portion (arrowheads).

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