Role of magnetic resonance imaging in the differentiation of mucinous ovarian carcinoma and mucinous borderline ovarian tumors

Abstract

Objective: This study was carried out to investigate the differentiation of mucinous borderline ovarian tumor from mucinous ovarian carcinoma using magnetic resonance imaging.

Methods: We evaluated 77 women patients who underwent abdominal magnetic resonance imaging due to pelvic mass. magnetic resonance imaging was reviewed by an experienced radiologist. A total of 70 women patients were included in the study. The magnetic resonance imaging features were retrospectively evaluated and compared between the two pathologies.

Results: There was no difference between the two groups in terms of maximum tumor size. Age at diagnosis was 56.29±11.92 in the mucinous ovarian carcinoma group and 44.74±13.60 in the mucinous borderline ovarian tumor group (p<0.05). A significant difference was found between the two groups, and it was observed that mucinous borderline ovarian tumors appeared in the younger age group compared to mucinous ovarian carcinomas. Presence of ascites, peritoneal dissemination, lymphadenopathy, and mural nodules was found significantly more frequently in mucinous ovarian carcinomas than in mucinous borderline ovarian tumors. Honeycomb appearance was found more frequently in mucinous borderline ovarian tumor patients than in mucinous ovarian carcinoma patients.

Conclusion: magnetic resonance imaging findings of these two pathologies overlapped considerably. Compared with mucinous borderline ovarian tumors, mucinous ovarian carcinomas frequently had mural nodules larger than 5 mm, larger tumor size, peritoneal dissemination, and abnormal ascites.

Figure 1.. A 42-year-old woman with mucinous borderline tumor. (A) Axial T2-weighted image shows multilocular cystic tumor with stained glass appearance (arrow) and honeycomb sign (arrowhead). (B) T1-weighted image shows multilocular cystic tumor with stained glass appearance. (C) Contrast-enhanced T1-weighted image shows enhanced multiple thin septa.

Figure 2.. A 53-year-old woman with mucinous carcinoma. (A and B) Axial and sagittal T2-weighted image shows a gross multilocular cystic tumor with a mildly hyperintense mural nodule larger than 5 mm (arrow). (C) Diffusion-weighted image shows a hyperintense mural nodule (arrow). (D) Apparent diffusion coefficient (ADC) map shows a low ADC value. (E) T1-weighted image shows a hypointense mural nodule (arrow). (F) Contrast-enhanced T1-weighted image shows a moderately enhanced mural nodule (arrow).