Xie Lijun, Liu Xinxiu, Li Haiying, Huang Liyan, Chen Fang, Wang Xingfu, Jiang Lei, Gan Ling
Department of Medical Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Medical Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Womens Health Rep (New Rochelle). 2022 May 10;3(1):523-532. doi: 10.1089/whr.2021.0140. eCollection 2022.
Ovarian serous surface papillary borderline tumor (OSSPBT) is very rare. Combined with clinical and pathological features, we aim to investigate the multimodal ultrasound features of OSSPBT.
There were only 18 patients diagnosed with OSSPBT among the 142 patients who were diagnosed with borderline serous ovarian tumor by pathology from June 2008 to December 2020 in our hospital. Their clinical data, conventional ultrasound, two-dimensional contrast-enhanced ultrasound (2D-CEUS), three-dimensional contrast-enhanced ultrasound (3D-CEUS) characteristics, pathology, and prognosis were retrospectively analyzed.
The 18 patients had no specific clinical symptoms. Multiple implantable nodules were found in 8 patients (44.4%), ascites in 13 patients (72.2%), and elevated carbohydrate antigen 125 (CA125) in 15 patients (83.3%). After excluding 2 misdiagnosed patients from 18 patients, 26 tumors in 16 patients (6 unilateral and 10 bilateral) were studied. Conventional ultrasound findings of OSSPBT showed that large solid masses around normal ovary without capsule, and numerous small dense anechoic areas were observed in the parenchyma of the lesion, with strong speckle echo ("blizzard" sign) of varying degrees. The 2D-CEUS and 3D-CEUS showed a normal ovary in the center surrounded by a radial blood supply of OSSPBT with thick and irregular branches. Histopathologically, the papillary fibrous stalk of OSSPBT had a large number of sand bodies and tortuous dilated microvessels. All patients had no recurrence after surgery, and two of them delivered successfully through assisted reproductive technology.
OSSPBT has a good prognosis. Its conventional ultrasound is characterized by irregular solid masses surrounding normal ovaries and a large number of "blizzard" signs. It showed low enhancement of eccentricity with irregular radial branches centered on the ovary by CEUS.
卵巢浆液性表面乳头状交界性肿瘤（OSSPBT）非常罕见。结合临床和病理特征，我们旨在研究OSSPBT的多模态超声特征。
2008年6月至2020年12月在我院经病理诊断为浆液性卵巢交界性肿瘤的142例患者中，仅18例被诊断为OSSPBT。对其临床资料、常规超声、二维对比增强超声（2D-CEUS）、三维对比增强超声（3D-CEUS）特征、病理及预后进行回顾性分析。
18例患者无特异性临床症状。8例患者（44.4%）发现多发可植入结节，13例患者（72.2%）有腹水，15例患者（83.3%）糖类抗原125（CA125）升高。18例患者中排除2例误诊患者后，对16例患者（6例单侧和10例双侧）的26个肿瘤进行研究。OSSPBT的常规超声表现为正常卵巢周围有大的实性肿块，无包膜，病变实质内可见大量小的密集无回声区，伴有不同程度的强斑点状回声（“暴风雪”征）。2D-CEUS和3D-CEUS显示中心为正常卵巢，周围为OSSPBT的放射状血供，分支粗大且不规则。组织病理学上，OSSPBT的乳头状纤维蒂有大量砂粒体和迂曲扩张的微血管。所有患者术后均无复发，其中2例通过辅助生殖技术成功分娩。
OSSPBT预后良好。其常规超声特征为正常卵巢周围有不规则实性肿块及大量“暴风雪”征。CEUS显示以卵巢为中心的偏心性低增强，有不规则放射状分支。
