Differentiation of Seromucinous Borderline Tumor from Serous Borderline Tumor on MR Imaging

Kurata, Yasuhisa; Kido, Aki; Moribata, Yusaku; Kameyama, Kyoko; Minamiguchi, Sachiko; Konishi, Ikuo; Togashi, Kaori

doi:10.2463/mrms.mp.2017-0055

Cited by 19 publications

(9 citation statements)

References 22 publications

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“…This finding is in good agreement with that of Kurata et al, reporting that SMBT showed a high intracystic fluid signal intensity on T1WI and a low signal intensity on T2WI. [2] The intracystic fluid signal intensity depends upon the electron paramagnetic effects of the different derivates of hemoglobin (oxyhemoglobin, methemoglobin, heme iron, and free iron) and the magnetic field strength. [12] Recent metallobiology study demonstrated that methemoglobin (ferric Fe 3+ ) was significantly more abundant in cyst fluids of benign OE than EAOC patients, while oxyhemoglobin (ferrous Fe 2+ ) was significantly more abundant in the cyst fluids of EAOC than benign OE.…”

Section: Discussionmentioning

confidence: 99%

“…Seromucinous borderline tumor (SMBT) is frequently associated with endometriosis that is a common gynecological disorder affecting women in the reproductive age group. [1,2] Endometriosis is a benign condition, but approximately 1% of the cases undergo malignant transformation (endometriosis-associated ovarian cancer [EAOC]) later in life. [3] EAOC includes clear cell carcinoma, endometrioid carcinoma, low-grade serous carcinoma, and SMBT.…”

Section: Introductionmentioning

confidence: 99%

“…[3] EAOC includes clear cell carcinoma, endometrioid carcinoma, low-grade serous carcinoma, and SMBT. [2,4]…”

Section: Introductionmentioning

confidence: 99%

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A diagnostic challenge of seromucinous borderline tumor

Liu¹,

Sumida²,

Wada³

et al. 2019

Medicine

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Introduction: Magnetic resonance (MR) relaxometry provides a noninvasive predictive tool to discriminate between benign ovarian endometrioma (OE) and endometriosis-associated ovarian cancer (EAOC). Transverse relaxation rate R2 value was determined using a single-voxel, multi-echo MR sequence (HISTO) by a 3T-MR system. R2 with cutoff value of 12.1 s −1 was established to discriminate between benign and malignant tumors. Patient concerns: We present a case of a 39-year-old woman who was initially thought to be malignant transformation of endometriosis by diagnostic MR imaging of the vascularized solid components. Diagnosis: A R2 value of 42.62 s −1 on MR relaxometry demonstrated that this case is non-malignant. Interventions: To confirm the diagnose, left salpingo-oophorectomy by laparoscopic surgery was performed. Outcomes: Histopathological results revealed seromucinous borderline tumor (SMBT). Our experience suggests that preoperative MR relaxometry may be useful for discriminating “borderline (SMBT)” from “malignancy (EAOC).” Furthermore, immunohistochemical studies of this case demonstrated ovarian SMBT cells were positive for estrogen receptor, progesterone receptor, and hepatocyte nuclear factor-1beta. A similar expression pattern was also observed in patients with benign OE. Lessons: In many respects, SMBT characteristics differ from those of EAOC but resemble those of benign OE. MR relaxometry unveils a new clinical approach as an adjunctive modality for discriminating SMBT from EAOC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A diagnostic challenge of seromucinous borderline tumor

Liu¹,

Sumida²,

Wada³

et al. 2019

Medicine

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“…A recent study which looked at the MRI findings of seromucinous tumors found evidence of endometriosis in more than half the cases and concluded that it was difficult to differentiate tumors diagnosed as seromucinous carcinomas from other endometriosis related carcinomas by imaging studies [ 14 ]. However, some other recent imaging studies have found certain imaging features on MRI which can help in distinguishing seromucinous tumors from other malignant ovarian tumors including endometriosis related tumors [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Ovarian seromucinous tumors: clinicopathological features of 10 cases with a detailed review of the literature

et al. 2021

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Background The 2014 WHO Classification of ovarian neoplasms introduced a new entity of seromucinous tumors associated with endometriosis. These tumors encompassed a spectrum from benign to malignant and included seromucinous cystadenoma/ cystadenofibroma, seromucinous borderline tumor/atypical proliferative seromucinous tumor and seromucinous carcinoma. However, the 2020 WHO Classification of Female Genital Tumours removed seromucinous carcinomas as a distinct entity and recategorized them as Endometrioid carcinomas with mucinous differentiation. Here we describe clinico-morphologic features of seromucinous tumors recategorizing cases originally diagnosed as seromucinous carcinoma in light of 2020 WHO classification and present detailed review of literature. Methods Slides of seromucinous tumors were reviewed. Special emphasis was given to evaluation of stromal invasion. Follow-up was obtained. Results Ten cases were diagnosed. Mean age was 40 years. Four cases were bilateral. Mean size was 19 cm. Grossly; luminal papillary projections were seen in 6 cases. Tumors demonstrated a papillary architecture with papillae lined by stratified seromucinous epithelium showing nuclear atypia. Stromal invasion was seen in 4 cases. Six cases were reported as borderline seromucinous tumors and 4 cases originally diagnosed as seromucinous carcinoma were recategorized as endometrioid carcinoma with mucinous differentiation on review. Endometriosis was seen in 4 cases. CK7, PAX8 and ER were positive in 7/7 cases. Two cases showed extra-ovarian involvement. Follow up was available in 7 cases. Six patients were alive and well at follow up ranging from 8 to 46 months. Six patients received chemotherapy postoperatively. One patient with carcinoma died of disease 18 months postoperatively. Conclusion In our series, 4 cases were originally diagnosed as seromucinous carcinomas. However, these were recategorized in light of the 2020 WHO Classification of Female Genital tumors as endometrioid carcinomas with mucinous differentiation. Six cases were diagnosed as seromucinous borderline tumors. Thus, majority of cases were borderline in agreement with published literature.

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“…MRI findings reflect these pathological characteristics, and it appears as an endometriotic cyst with papillary mural nodules (Fig. 12 ) [ 39 ]. The mural nodules show as dendritic hypointensity with surrounding markedly hyperintense areas on T2WI (Fig.…”

Section: Cystic Mass With Mural Nodule or Solid Component Related To ...mentioning

confidence: 99%

Magnetic resonance imaging findings of cystic ovarian tumors: major differential diagnoses in five types frequently encountered in daily clinical practice

Ohya

Fujinaga

2022

Jpn J Radiol

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There are many types of ovarian tumors, and these different types often form cystic masses with a similar appearance, which can make their differentiation difficult. However, with the exclusion of rare ovarian tumors, the number of ovarian tumors encountered in daily practice is somewhat fixed. It goes without saying that magnetic resonance imaging (MRI) is useful for differentiating ovarian tumors. In this review, we summarize the differential diagnoses for each of the five types of MRI findings commonly encountered in daily practice. First, unilocular cystic masses without mural nodules/solid components include benign lesions such as serous cystadenoma, functional cysts, surface epithelial inclusion cysts, paratubal cysts, and endometriosis. Second, multilocular cystic ovarian lesions include mucinous tumors and ovarian metastases. It should be noted that mucinous tumors may be diagnosed as borderline or carcinoma, even if no solid component is observed. Third, cystic lesions with mural nodules that are unrelated to endometriosis include serous borderline tumor and serous carcinoma. Cystic lesions with solid components are more likely to be malignant, but some may be diagnosed as benign. Fourth, ovarian tumors deriving from endometriosis include seromucinous borderline tumors, endometrioid carcinoma, and clear cell carcinoma. These tumors sometimes need to be differentiated from serous tumors. Finally, cystic lesions with lipid contents include teratoma-related tumors. In mature cystic teratoma, mural nodules (called “Rokitansky protuberance” or “dermoid nipple”) are sometimes seen, but they do not suggest malignancy. Some of these lesions can be diagnosed accurately by considering their characteristic imaging findings, their changes over time, MRI findings other than those of the primary lesion, and information from other modalities such as tumor markers. To ensure the optimal treatment for ovarian tumors, it is important to estimate the histological type as well as to diagnose whether a lesion is benign or malignant.

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Differentiation of Seromucinous Borderline Tumor from Serous Borderline Tumor on MR Imaging

Cited by 19 publications

References 22 publications

A diagnostic challenge of seromucinous borderline tumor

A diagnostic challenge of seromucinous borderline tumor

Ovarian seromucinous tumors: clinicopathological features of 10 cases with a detailed review of the literature

Magnetic resonance imaging findings of cystic ovarian tumors: major differential diagnoses in five types frequently encountered in daily clinical practice

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