Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors)
Objective To describe the clinical and sonographic characteristics of malignant ovarian yolk sac tumors (YSTs). Methods In this retrospective multicenter study, we included 21 patients with a histological diagnosis of ovarian YST and available transvaginal ultrasound images and/or videoclips a...
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| Format: | info:eu-repo/semantics/article |
| Language: | eng |
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USA
2023
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| Online Access: | https://hdl.handle.net/10171/66339 |
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| author | Anfelter, P. (P.) Testa, A.C. (Antonia Carla) Chiappa, V. (Valentina) Froyman, W. (Wouter) Fruscio, R. (Robert) Guerriero, S. (Stefano) Alcazar, J.L. (Juan Luis) Mascillini, F. (F.) Pascual, M.A. (Maria Angela) Sibal, M. (M) Savelli, L. (L.) Zannoni, G.F. (G.F.) Timmerman, D. (Dirk) Epstein, E. (E.) |
| author_facet | Anfelter, P. (P.) Testa, A.C. (Antonia Carla) Chiappa, V. (Valentina) Froyman, W. (Wouter) Fruscio, R. (Robert) Guerriero, S. (Stefano) Alcazar, J.L. (Juan Luis) Mascillini, F. (F.) Pascual, M.A. (Maria Angela) Sibal, M. (M) Savelli, L. (L.) Zannoni, G.F. (G.F.) Timmerman, D. (Dirk) Epstein, E. (E.) |
| author_sort | Anfelter, P. (P.) |
| collection | DSpace |
| description | Objective To describe the clinical and sonographic
characteristics of malignant ovarian yolk sac tumors
(YSTs).
Methods In this retrospective multicenter study, we
included 21 patients with a histological diagnosis of
ovarian YST and available transvaginal ultrasound
images and/or videoclips and/or a detailed ultrasound
report. Ten patients identified from the International Results All cases were pure YSTs, except for one that
was a mixed tumor (80% YST and 20% embryonal
carcinoma). Median age at diagnosis was 25 (interquartile
range (IQR), 19.5–30.5) years. Seventy-six percent
(16/21) of women had an International Federation of
Gynecology and Obstetrics (FIGO) Stage I–II tumor at
diagnosis. Fifty-eight percent (11/19) of women felt pain
during the ultrasound examination and one presented
with ovarian torsion. Median serum α-fetoprotein (S-AFP)
level was 4755 (IQR, 1071–25 303) μg/L and median
serum CA 125 level was 126 (IQR, 35–227) kU/L. On
ultrasound assessment, 95% (20/21) of tumors were
unilateral. The median maximum tumor diameter was
157 (IQR, 107–181) mm and the largest solid component
was 110 (IQR, 66–159) mm. Tumors were classified as either multilocular-solid (10/21; 48%) or solid (11/21;
52%). Papillary projections were found in 10% (2/21) of
cases. Most (20/21; 95%) tumors were well vascularized
(color score, 3–4) and none had acoustic shadowing.
Malignancy was suspected in all cases, except in the
patient with ovarian torsion, who presented a tumor with
a color score of 1, which was classified as probably benign.
Image and videoclip quality was considered as adequate
in 18/21 cases. On review of the images and videoclips, we
found that all tumors contained both solid components
and cystic spaces, and that 89% (16/18) had irregular, still
fine-textured and slightly hyperechoic solid tissue, giving
them a characteristic appearance.
Conclusion Malignant ovarian YSTs are often detected
at an early stage, in young women usually in the second
or third decade of life, presenting with pain and markedly
elevated S-AFP. On ultrasound, malignant ovarian YSTs
are mostly unilateral, large and multilocular-solid or solid,
with fine-textured slightly hyperechoic solid tissue and
rich vascularization. © 2020 The Authors. Ultrasound
in Obstetrics & Gynecology published by John Wiley
& Sons Ltd on behalf of the International Society of
Ultrasound in Obstetrics and Gynecology. |
| format | info:eu-repo/semantics/article |
| id | oai:dadun.unav.edu:10171-66339 |
| institution | Universidad de Navarra |
| language | eng |
| publishDate | 2023 |
| publisher | USA |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-663392023-06-08T12:09:55Z Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) Anfelter, P. (P.) Testa, A.C. (Antonia Carla) Chiappa, V. (Valentina) Froyman, W. (Wouter) Fruscio, R. (Robert) Guerriero, S. (Stefano) Alcazar, J.L. (Juan Luis) Mascillini, F. (F.) Pascual, M.A. (Maria Angela) Sibal, M. (M) Savelli, L. (L.) Zannoni, G.F. (G.F.) Timmerman, D. (Dirk) Epstein, E. (E.) Endodermal sinus tumor Malignant germ-cell tumor Ultrasound features Yolk sac tumor Objective To describe the clinical and sonographic characteristics of malignant ovarian yolk sac tumors (YSTs). Methods In this retrospective multicenter study, we included 21 patients with a histological diagnosis of ovarian YST and available transvaginal ultrasound images and/or videoclips and/or a detailed ultrasound report. Ten patients identified from the International Results All cases were pure YSTs, except for one that was a mixed tumor (80% YST and 20% embryonal carcinoma). Median age at diagnosis was 25 (interquartile range (IQR), 19.5–30.5) years. Seventy-six percent (16/21) of women had an International Federation of Gynecology and Obstetrics (FIGO) Stage I–II tumor at diagnosis. Fifty-eight percent (11/19) of women felt pain during the ultrasound examination and one presented with ovarian torsion. Median serum α-fetoprotein (S-AFP) level was 4755 (IQR, 1071–25 303) μg/L and median serum CA 125 level was 126 (IQR, 35–227) kU/L. On ultrasound assessment, 95% (20/21) of tumors were unilateral. The median maximum tumor diameter was 157 (IQR, 107–181) mm and the largest solid component was 110 (IQR, 66–159) mm. Tumors were classified as either multilocular-solid (10/21; 48%) or solid (11/21; 52%). Papillary projections were found in 10% (2/21) of cases. Most (20/21; 95%) tumors were well vascularized (color score, 3–4) and none had acoustic shadowing. Malignancy was suspected in all cases, except in the patient with ovarian torsion, who presented a tumor with a color score of 1, which was classified as probably benign. Image and videoclip quality was considered as adequate in 18/21 cases. On review of the images and videoclips, we found that all tumors contained both solid components and cystic spaces, and that 89% (16/18) had irregular, still fine-textured and slightly hyperechoic solid tissue, giving them a characteristic appearance. Conclusion Malignant ovarian YSTs are often detected at an early stage, in young women usually in the second or third decade of life, presenting with pain and markedly elevated S-AFP. On ultrasound, malignant ovarian YSTs are mostly unilateral, large and multilocular-solid or solid, with fine-textured slightly hyperechoic solid tissue and rich vascularization. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. 2023-05-23T09:46:38Z 2023-05-23T09:46:38Z 2020 info:eu-repo/semantics/article https://hdl.handle.net/10171/66339 eng info:eu-repo/semantics/openAccess application/pdf USA |
| spellingShingle | Endodermal sinus tumor Malignant germ-cell tumor Ultrasound features Yolk sac tumor Anfelter, P. (P.) Testa, A.C. (Antonia Carla) Chiappa, V. (Valentina) Froyman, W. (Wouter) Fruscio, R. (Robert) Guerriero, S. (Stefano) Alcazar, J.L. (Juan Luis) Mascillini, F. (F.) Pascual, M.A. (Maria Angela) Sibal, M. (M) Savelli, L. (L.) Zannoni, G.F. (G.F.) Timmerman, D. (Dirk) Epstein, E. (E.) Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| title | Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| title_full | Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| title_fullStr | Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| title_full_unstemmed | Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| title_short | Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| title_sort | imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors) |
| topic | Endodermal sinus tumor Malignant germ-cell tumor Ultrasound features Yolk sac tumor |
| url | https://hdl.handle.net/10171/66339 |
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