Jiang Qiaosheng, Sun Chen, Li Jia, Fu Jieting
Department of Radiology, Jinhua Central Hospital Jinhua 321000, Zhejiang, China.
Department of Radiology, Jinhua Maternal & Child Health Care Hospital Jinhua 321000, Zhejiang, China.
Am J Transl Res. 2023 Feb 15;15(2):1452-1461. eCollection 2023.
The occurrence of extramedullary plasmacytoma (EMP) in the ovaries is rare. Here, we describe the clinical, pathological and radiological presentations of ovarian plasmacytomas to improve the differential diagnosis of this disease. Also, the reasons for misdiagnosis, clinical manifestations and radiological features were discussed through a literature review.
A 54-year-old woman was suspected to have EMP upon routine ultrasound examination and was subsequently diagnosed using pathological examination of the left ovarian mass. The radiological features of this case included (1) a solitary soft-tissue mass in the left ovary with clear boundaries; (2) a homogeneous mass with medium-density without necrosis, which was homogeneously enhanced after contrast medium injection; and (3) magnetic resonance imaging showing a homogeneous lesion with isointense signals on T1- and T2-weighted imaging, restricted diffusion on diffusion-weighted imaging, and a low apparent diffusion coefficient value of approximately 0.72×10 mm/s, which was significantly and homogeneously enhanced after contrast medium injection with a rapid rise-slow decay type, and with thickened vascular shadows around the lesion.
EMP in the ovary is rare and only a few cases have been reported. We reviewed EMP-related literature and the summarized the clinical manifestations, radiological features and treatment strategies of this disease to help the diagnosis and management. Application of second-line drugs might be a viable strategy to improve the survival rate of patients and to prevent the progression to a certain extent.
卵巢髓外浆细胞瘤(EMP)的发生较为罕见。在此,我们描述卵巢浆细胞瘤的临床、病理及影像学表现,以提高对该疾病的鉴别诊断。此外,通过文献回顾探讨误诊原因、临床表现及影像学特征。
一名54岁女性在常规超声检查时疑似患有EMP,随后经左侧卵巢肿块的病理检查确诊。该病例的影像学特征包括:(1)左侧卵巢内一个边界清晰的孤立软组织肿块;(2)密度均匀的中等密度肿块,无坏死,注射造影剂后均匀强化;(3)磁共振成像显示在T1加权和T2加权成像上呈等信号的均匀病变,扩散加权成像上扩散受限,表观扩散系数值约为0.72×10⁻³mm²/s,注射造影剂后呈快速上升-缓慢下降型显著且均匀强化,病变周围血管影增粗。
卵巢EMP罕见,仅有少数病例报道。我们回顾了与EMP相关的文献,总结了该疾病的临床表现、影像学特征及治疗策略,以助于诊断和管理。应用二线药物可能是提高患者生存率并在一定程度上预防疾病进展的可行策略。