Adnexal Masses in Women with Breast Cancer: US Findings with Clinical and Histopathologic Correlation

Hann, Lucy E.; Lui, Delphine M.; Shi, Wei; Bach, Ariadne M.; Selland, Donna-Lee G.; Castiel, Mercedes

doi:10.1148/radiology.216.1.r00jl15242

Cited by 60 publications

(42 citation statements)

References 22 publications

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“…These results are in agreement with some previously published studies that have shown that breast metastases to the ovary 12 and Krukenberg tumors 13,14 had a solid sonographic appearance. We also found no differences in vascular features, as assessed by color Doppler sonography, between primary ovarian cancers and metastatic tumors.…”

supporting

confidence: 93%

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Alcázar

Galán

Ceamanos

et al. 2003

Journal of Ultrasound in Medicine

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Objective. To compare gray scale and color Doppler features of primary and metastatic ovarian carcinomas. Methods. Clinical, sonographic (gray scale and color Doppler), and histopathologic data of 143 patients with primary (n = 127 adnexal masses) and metastatic (n = 34 adnexal masses) ovarian cancer were reviewed. Morphologic gray scale parameters assessed were bilaterality, tumor volume, echogenicity, and presence of septa, papillary projections, or solid areas. Color Doppler parameters were presence of blood flow, tumor blood flow location (central versus peripheral), subjective impression of blood flow amount (scanty, moderate, or abundant), lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity (centimeters per second). Results. No statistical differences were found in bilaterality, tumor volume, presence of septa, papillary projections or solid areas, presence of blood flow, tumor blood flow location, subjective impression of blood flow amount, lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity. Metastatic carcinomas were more frequently purely solid tumors (47% versus 26%; P = .001; likelihood ratio, 2.4; 95% confidence interval, 1.2-4.7). Conclusions. The presence of a purely solid tumor indicates a higher probability of metastatic carcinoma than primary ovarian cancer. However, with the use of gray scale and color Doppler sonography, it is difficult to differentiate primary ovarian carcinomas from metastatic tumors to the ovary. Key words: color Doppler sonography; metastatic cancer; ovarian cancer; sonography.Received September 20, 2002, hen an ovarian tumor is identified as questionable at sonographic examination, primary ovarian cancer should be the main concern. However, about 5% to 30% of malignant ovarian tumors are metastatic tumors to the ovary. 1 The preoperative distinction between primary ovarian cancers and metastatic lesions might be of clinical relevance, because surgery is of the utmost importance in the treatment of primary ovarian cancer, given that optimal cytoreduction and accurate surgical staging are 2 of the most important prognostic factors in this disease. 2,3 However, this surgical effort in metastatic cancers to the ovary might not be worthwhile. 4

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supporting

confidence: 93%

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Alcázar

Galán

Ceamanos

et al. 2003

Journal of Ultrasound in Medicine

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“…Ovarian metastasis from breast cancer are reported at autopsy in 2.6% to 23.4% in large series, and at oophorectomy for metastatic disease in 25% of patients with breast cancer [7]. Tserkezoglou et al [8], reported the median age of nine patients who had ovarian metastasis from breast cancer to be 54 (rang, 39-73), while others have reported a median age of about 46-50 [3,4].…”

Section: Discussionmentioning

confidence: 99%

A young patient in Korea with Krukenberg tumors arising from breast cancer: A case report

Kwon

Nam

Kim

et al. 2011

Korean J Obstet Gynecol

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Metastasis of breast cancer to lung, bone and liver is common, but metastasis to ovaries is rare in Korea. A 31-year-old woman diagnosed with breast cancer was referred to our department due to a newly detected adnexal mass via abdomen sonography during regular check-up. Imaging studies revealed solid mass on left ovary and enlarged lymph nodes. She underwent a laparotomy including hysterectomy, bilateral salpingo-oophorectomy, lymphadenectomy, with a suspected impression of primary ovarian neoplasms or Krukenberg tumors. Pathologic fi ndings revealed metastatic adenocarcinoma from breast cancer involving left ovary and paraaortic lymph nodes. To our knowledge, this is the youngest Korean patient with Krukenberg tumors from the breast. In Korea, since the average age affected by breast cancer is younger than in the West, and the incidence and the mortality of breast cancer has increased, possible ovarian metastasis should be kept in mind when Korean patient with breast cancer visits for follow-up. Krukenberg tumors, which refer to metastatic ovarian tumors originating from various sites, account for about 0.7-6.7% of ovarian tumors and 10-30% of malignant ovarian tumors [1,2]. The primary origin sites are usually the gastrointestinal (GI) tract, including the stomach and colon, the gall bladder/biliary tract, breast and others. In both Asia and the West, most metastatic ovarian tumors originate from the GI tract; others origin show different proportions because of the incidence and commonly affected ages of primary cancer. Ovarian metastasis from breast cancer is not frequent in Asia and breast cancer in Asian women occurs at a younger age between 30 and 40 with locally-advanced stage III disease, unlike the West where women typically present after age 50 with early stage disease. Here we present the case of the youngest patient in Korea with Krukenberg tumors arising from breast cancer. Case ReportA 31-year-old married female (gravida 2, para 2) was diagnosed with left breast cancer involving axillary lymph nodes metastasis CASE REPORT Korean J Obstet Gynecol 2011;54(10):643-646 http://dx

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“…Over metastazlannın kendine özgü bir görünümü yoktur fakat genellikle bilateral ve yoğun kontrast tutan kitlelerdir. 20,21 Bizim çalışmamızda bilateral tutulum gösteren meme Ca metastazı mevcut olguda, US'da bilateral adnekste solid kitle lezyonları malign olarak değerlendirildi. MRG'de T2 intensitesinin myometrium ile izointens olması nedeni ile fibrom ekarte edilemedi.…”

Section: -5unclassified

•Pelvic magnetic resonance imaging in gynecologic masses

Asal¹,

Koşar²,

Duymuş³

et al. 2011

Dicle Med J

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ÖZETAmaç: Bu çalışmanın amacı adneksiyel ve uterin kitle olgularında pelvik manyetik rezonans görüntüleme (MRG) tetkikinin tanısal etkinliğini ve ultrasonografi (US)'ye katkısını değerlendirmektir. Gereç ve yöntem:Jinekolojik kitle ön tanısı ile başvuran (10-83 yaş arası) 62 hastadan 61'ine pelvik MRG incelemesi gerçekleştirildi. Bu hastaların içerisinden patoloji sonuçlarına ulaşılabilen ve takip sonuçları ile tanı konabilen 53 hasta çalışmaya dahil edildi. Hastalara çekim öncesi veya sonrasında birkaç gün içerisinde sadece transvajinal sadece transabdominal ya da transvajinal ve transabdominal yolla US incelemesi gerçekleştirildi. Çalışmaya dahil edilen hastaların postoperatif patoloji sonuçları ve opere olmayan hastalarda ise klinik ve radyolojik takip kesin tanı kabul edildi. Sonuçlar US ve MRG bulguları ile karşılaştırıldı.Bulgular: 53 hastada 62 pelvik lezyon saptandı. Lezyonların 42 (%66) tanesini adneksiyel kitle, 34 (%33) tanesini uterin patolojiler oluşturmaktaydı. Adneksiyel kitle saptanan 6 hastada bilateral adneksiyel lezyon, 3 hastada da ovoadneksiyel lojda aynı tarafta iki farklı lezyon saptandı. Uterin kitlelerin 14'ü serviks Ca, 4'ü leiomyom, 1'i endometrium Ca, 1 olgu da vajen Ca olarak belirlendi. MRG'de adneksiyel kitlelerin 40'ı (40/42), US'da 38'i (38/42) vizualize edilebildi. MRG ve US'da uterin kitlelerin tümü vizualize edilebildi. Benign-malign kitlelerin ayırımı US ile % 80, MRG ile %85 doğrulukta yapıldı.Sonuç: MRG, iyi kontrast rezolüsyonu, multıplanar ve multısekans görüntüleme ve yumuşak doku patolojilerinin gösterilmesindeki üstünlükleri ile jinekolojik kitlelerin orijini ve karakterizasyonunda US'ye üstündür. Ancak bü-tün hastalarda jinekolojik bulgu dahilinde ilk görüntüleme yöntemi US olmalı, klinik şüphe halinde MRG'ye başvu-rulmalıdır.Anahtar kelimeler: Adneksiyel kitle, manyetik rezonans görüntüleme, ultrasonografi ABSTRACT Objective: The aim of this study was to evaluate the diagnostic efficiency and the addition of the pelvic magnetic resonance imaging (MRI) to the ultrasonography (US) in adnexal and uterine masses. Materials and methods:Magnetic resonance imaging was performed to 61 patients (age 10-83 years) who refer with gynecologic mass prediagnosis. The study includes 53 patients having histopathological diagnosis and follow up results. Transvaginal, transabdominal or pelvic US were performed to all patients before or after a few days of MRI. Postoperative histopathological results and clinical and radiological follow up were used for definite diagnosis. The results verified with US and MRI findings. Results:Totally 62 pelvic lesions detected in 53 patients. Forty-two of 62 lesions (66%) were adnexal masses, 20 of 62 lesions were uterine (34%) masses, six patients had bilateral adnexal lesions and three had two different lesions in the same ovoadnexal side. Fourteen of the uterine masses were cervix cancer, four were leiomyoma, one was endometrium cancer and one vaginal cancer. Forty (40/42) adnexal masses detected in MRI, and 38 (38/42) were detected in US. Distincti...

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Adnexal Masses in Women with Breast Cancer: US Findings with Clinical and Histopathologic Correlation

Cited by 60 publications

References 22 publications

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

A young patient in Korea with Krukenberg tumors arising from breast cancer: A case report

•Pelvic magnetic resonance imaging in gynecologic masses

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