Review of atypical pelvic masses on CT and MRI: expanding the differential diagnosis

Vahidi, Kiarash; Joe, Bonnie N.; Meng, Maxwell V.; Coakley, Fergus V.; Yeh, Benjamin M.

doi:10.1016/j.clinimag.2007.06.023

Cited by 8 publications

(14 citation statements)

References 10 publications

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“…Preoperative differential diagnoses for masses in the perivesical or periprostatic soft tissue include some diseases, such as teratoma, prostate cancer arising in EPT, and metastatic neoplasm from the prostate or other organs [8,9]. As reaching a definite diagnosis based solely on imaging findings is difficult, histological examination of atypical pelvic masses is necessary.…”

Section: Discussionmentioning

confidence: 99%

Prostatic Adenocarcinoma With Pseudocapsule

Satô

2013

World J Nephrol Urol

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A 72-year-old man was referred to our hospital for treatment of prostatic adenocarcinoma with atypical imaging findings. The periprostatic mass was distinguishable from the prostate on magnetic resonance imaging, although the prostatic adenocarcinoma had been identified by needle biopsy at a previous hospital. To confirm the site of prostatic adenocarcinoma, transrectal ultrasonographydirected biopsy of the prostate and solitary mass was performed in our hospital. Diagnosis by re-biopsy revealed prostatic adenocarcinoma existing as a solitary mass. Radical prostatectomy was performed with no evidence of metastasis on imaging findings. Intraoperative findings revealed no adhesion between the prostate and pelvic floor. Pathological diagnosis revealed negative surgical margins, and a thin crust surrounding the adenocarcinoma. Strict pathological examination indicated a tiny adenocarcinoma existing within morphologically normal prostate tissue comprising nearly the entire mass. Based on these results, the final pathological diagnosis was locally advanced adenocarcinoma with pseudocapsule. In the present case, we concluded that a tiny prostatic adenocarcinoma had expanded in the lateral pelvic fascia, which formed a pseudocapsule. By 14 months postoperatively, prostate-specific antigen levels had decreased below the limit of detection. To the best of our knowledge, prostatic adenocarcinoma with pseudocapsule has not been described previously.

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Section: Discussionmentioning

confidence: 99%

Prostatic Adenocarcinoma With Pseudocapsule

Satô

2013

World J Nephrol Urol

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“…Additionally, the feeding artery had no mesh-like branches within the tumor, consistent with the findings of Zhang et al (16). Mixed cystic and solid pelvic tumors and solid pelvic tumors can be either benign or malignant (7)(8)(9). In our study, malignant tumors usually had two or more feeding arteries of different origins, while benign tumors were mainly fed by a single blood vessel.…”

Section: Discussionmentioning

confidence: 93%

“…MSCT angiography has an emerging clinical role in vascular imaging. It has potentially significant advantages over conventional angiography and CT scans in pelvic tumor diagnosis, especially with regard to differentiating between benign and malignant disease states and assisting in disease management (8)(9)(10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

“…A small number of these tumors form ectopic masses directly in the abdominopelvic cavity. In such cases, the source organ is often disfigured, and thus, it can be difficult to differentiate such tumors from tumors arising from abdominal organs (1,(8)(9)(10). Imaging can reveal characteristics that differentiate the origin of pelvic tumor, especially gynecological origin tumors from non-gynecological origin tumors (1).…”

Section: Discussionmentioning

confidence: 99%

“…This finding was similar to those of other studies such as Catalano et al (14), in which MSCT angiography delivered excellent results in assessing abdominopelvic tumor vascular involvement. Pelvic tumors of unknown origin often have an occult onset with atypical symptoms; common bladder, prostatic, or gynecologic causes should be ruled out during the initial assessment (8). Imaging is required to distinguish between gynecological, gastrointestinal, and neurogenic origin tumors as all can present similarly in the pelvic region (1).…”

Section: Discussionmentioning

confidence: 99%

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Tumor feeding artery reconstruction with multislice spiral CT in the diagnosis of pelvic tumors of unknown origin

Hai-jing

Huang

Zhu³

2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to compare multislice spiral computed tomography (MSCT) angiography diagnosis with both surgical findings and postoperative pathological results in patients with pelvic tumors of unknown origin. In addition, the diagnostic accuracy of MSCT angiography was compared with that of routine computed tomography for tumor feeding artery volume reconstruction to determine the origin and nature of pelvic tumors. MATERIALS AND METHODSThe records of 43 patients with pelvic tumors of unknown origin who underwent MSCT angiography were retrospectively reviewed. Volume reconstructions using add vessel and merge views methods were performed for abdominal and pelvic blood vessels. The tumor origin was identified based on observations of the origin, number, morphology, starting/ending locations, route, and distribution of the tumor feeding arteries. RESULTSOverall, the mean tumor diameter was 9.8±3.5 cm (range, 4.2-23.5 cm); 11 tumors (25.6%) were cystic in nature; and 32 tumors (74.4%) were either solid/cystic or solid in nature. When considering all MSCT angiography examinations used to predict the nature of the tumor (e.g., malignant or benign), the sensitivity and specificity were 77.3% and 95.2%, respectively. The positive and negative predictive values were 94.4% and 80%, respectively. The overall diagnostic accuracy was 86.05% with an area under the curve of 0.961 (95% confidence interval, 0.913-1.000). CONCLUSIONS MSCT angiography volume reconstruction for pelvic tumor feeding arteries of unknown origin is highly valuable for localization, qualitative diagnosis, and quantitative diagnosis of pelvic tumors.

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