MRI findings of malignant transformation arising from mature cystic teratoma of the ovary: comparison with benign mature cystic teratoma

Jpn J Radiol. 2024 May;42(5):500-507. doi: 10.1007/s11604-023-01521-z. Epub 2023 Dec 26.

Abstract

Objective: This study aimed to evaluate the efficacy of MRI findings to differentiate malignant transformation arising from mature cystic teratoma (MT-MCT) of the ovary from benign mature cystic teratoma (BMCT).

Materials and methods: This study included 11 patients with histopathologically proven MT-MCT and 50 with BMCT. Overall, 7 patients with MT-MCT and all 50 with BMCT underwent unenhanced and contrast-enhanced MRIs and 4 with MT-MCT only underwent unenhanced MRIs. The MRI findings were evaluated and compared between the two diseases.

Results: The median age (55 vs. 38 years, p < 0.01) and maximum diameter (109 vs. 65 mm, p < 0.01) were higher in MT-MCT than in BMCT. Fat component occupancy was lower in MT-MCT than in BMCT (median, 5% vs. 63%, p < 0.01). Only MT-MCT exhibited irregular tumor margins (64%), peritoneal dissemination (18%), and abnormal ascites (27%). The solid components were more commonly observed in MT-MCT than in BMCT (100% vs. 32%, p < 0.01) on contrast-enhanced images. The maximum diameter of solid components in MT-MCT was larger than that in BMCT (median, 61 mm vs. 14 mm, p < 0.01). In MT-MCT, the common configuration of solid components was endophytic or exophytic sessile (85%), whereas in BMCT, it was endophytic papillary (88%).

Conclusion: Compared with BMCT, MT-MCT demonstrated a larger maximum diameter, lower occupancy rate of fat components, and sessile solid components. The characteristic configuration of solid components was endophytic or exophytic sessile in MT-MCT and endophytic papillary in BMCT.

Keywords: Benign; MRI; Malignant; Ovary; Teratoma.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cell Transformation, Neoplastic*
  • Contrast Media*
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Middle Aged
  • Ovarian Neoplasms* / diagnostic imaging
  • Ovarian Neoplasms* / pathology
  • Ovary / diagnostic imaging
  • Ovary / pathology
  • Retrospective Studies
  • Teratoma* / diagnostic imaging
  • Teratoma* / pathology
  • Young Adult

Substances

  • Contrast Media

Supplementary concepts

  • Teratoma, Ovarian