Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy.
Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
Int J Gynecol Cancer. 2020 Sep;30(9):1384-1389. doi: 10.1136/ijgc-2020-001276. Epub 2020 May 30.
Ultrasound features of granulosa cell tumors of the ovary are still poorly defined. The aim of this study is to widen current knowledge on the role of sonographic gray scale and pattern recognition in the characterization of these tumors and to compare the ultrasound characteristics of primary diagnosis and recurrences.
Transvaginal ultrasound images of primary diagnosis or recurrences of histologically-confirmed granulosa cell tumors of the ovary were retrospectively retrieved from a dedicated database designed for the collection of clinical and ultrasound data from January 2001 to January 2019. All patients included were treated at San Raffaele and Santa Chiara Hospitals. Women with a concomitant diagnosis of another malignancy other than endometrial carcinoma were excluded from the study. All ultrasound images were described according to International Ovarian Tumor Analysis terminology and examined by experienced ultrasound examiners.
A total of 27 patients were included: 24 with adult and 3 with juvenile ovarian granulosa cell tumors. At primary diagnosis, mean ovarian mass size was 103.8 mm (range 30-200). On ultrasound evaluation at primary diagnosis, 12 patients presented with a multilocular solid lesion (48%), 9 with a solid lesion (36%), and 4 with a multilocular lesion(16%). The echogenicity of the cyst was low level or anechoic, mixed, or hemorrhagic in 56.3%, 31.2%, and 12.5% of cases, respectively. Most tumors (45.1%), including first diagnosis and relapses, had a moderate to high color score on doppler evaluation.
Our study showed that sonographic features and pattern recognition of relapses were comparable to those of tumors at primary diagnosis. In order to highlight the importance of transvaginal ultrasound evaluation during follow-up, further studies based on a standardized ultrasound characterization of ovarian masses are recommended.
卵巢颗粒细胞瘤的超声特征仍未得到明确界定。本研究旨在拓宽当前对超声灰阶和模式识别在这些肿瘤特征描述中的作用的认识，并比较原发性和复发性肿瘤的超声特征。
从 2001 年 1 月至 2019 年 1 月专门用于收集临床和超声数据的数据库中回顾性检索经组织学证实的卵巢颗粒细胞瘤的原发性或复发性经阴道超声图像。所有纳入的患者均在圣拉斐尔和圣恰拉医院接受治疗。患有除子宫内膜癌以外的另一种恶性肿瘤的女性被排除在研究之外。所有超声图像均根据国际卵巢肿瘤分析术语进行描述，并由经验丰富的超声检查人员进行检查。
共纳入 27 例患者：24 例为成人颗粒细胞瘤，3 例为幼年颗粒细胞瘤。在原发性诊断时，卵巢肿块的平均大小为 103.8mm（范围为 30-200）。在原发性诊断时的超声评估中，12 例表现为多房实性病变（48%），9 例为实性病变（36%），4 例为多房病变（16%）。囊的回声强度分别为低水平或无回声、混合性或出血性，分别占 56.3%、31.2%和 12.5%。大多数肿瘤（45.1%），包括首次诊断和复发，在多普勒评估中具有中等至高的彩色评分。
本研究表明，复发性肿瘤的超声特征和模式识别与原发性肿瘤相似。为了突出经阴道超声评估在随访中的重要性，建议进一步开展基于卵巢肿块标准化超声特征描述的研究。
