Kajiyama Akiko, Edo Hiromi, Takeya Chiaki, Kubushiro Kaneyuki, Oharaseki Toshiaki, Gomi Tatsuya
Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan.
Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
Am J Case Rep. 2017 Aug 24;18:919-925. doi: 10.12659/ajcr.904462.
BACKGROUND Paraovarian cysts are common and are generally benign; however, they are frequently misdiagnosed as being of ovarian origin. Conversely, paraovarian tumors of borderline malignancy are extremely rare. Especially, no cases of spontaneous rupture have been reported, and all previous reports had normal serum carbohydrate antigen (CA) 125 level. As for imaging findings, the presence of papillary projections in the lumen of paraovarian tumors does not always indicate malignancy or benignancy, which makes the preoperative distinction difficult. CASE REPORT We report a case involving a 22-year-old Asian woman with a spontaneously ruptured paraovarian tumor of borderline malignancy. The serum CA125 concentration was extremely elevated, at 28,831 U/mL. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a collapsed unilocular cystic lesion with multiple papillary projections. On MRI, the papillary projections showed two different patterns, which corresponded to the pathological findings. CONCLUSIONS Ruptured paraovarian tumors of borderline malignancy may show extremely high serum CA125 values. Furthermore, specific MRI findings may be useful in evaluating the malignancy of paraovarian tumors.
卵巢旁囊肿很常见，通常为良性；然而，它们常被误诊为卵巢来源。相反，交界性恶性卵巢旁肿瘤极为罕见。特别是，尚无自发破裂的病例报道，且既往所有报道的血清糖类抗原（CA）125水平均正常。关于影像学表现，卵巢旁肿瘤腔内出现乳头状突起并不总是提示恶性或良性，这使得术前鉴别困难。病例报告：我们报告一例22岁亚洲女性，患有自发破裂的交界性恶性卵巢旁肿瘤。血清CA125浓度极度升高，达28831 U/mL。计算机断层扫描（CT）和磁共振成像（MRI）显示一个塌陷的单房囊性病变，伴有多个乳头状突起。在MRI上，乳头状突起表现出两种不同模式，与病理结果相符。结论：破裂的交界性恶性卵巢旁肿瘤可能表现出极高的血清CA125值。此外，特定的MRI表现可能有助于评估卵巢旁肿瘤的恶性程度。
