Significance of the solid component in predicting malignancy in ovarian cystic teratomas: diagnostic considerations.
OBJECTIVE
To determine whether gray scale characteristics of the solid components of cystic ovarian teratomas exist that could differentiate more common benign forms from malignant variants.


METHODS
We retrospectively reviewed the sonographic images of 188 ovarian teratomas that contain at least a 25% cystic component and correlated the images with the final diagnosis. Features of the solid component assessed included its echo texture, overall appearance, shape, size, and internal homogeneity.


RESULTS
One-hundred seventy-seven teratomas were benign, and 11 were malignant; among the malignant masses, 7 were high grade. Of the benign forms, 155 solid components (88%) were hyperechoic, 168 (95%) were focal in appearance, 105 (59%) were nodular in shape, and 123 (69%) were uniformly solid. Of the malignant types, 9 solid components (82%) were isoechoic, 6 (55%) had branching, 6 (55%) were irregular in shape, and 8 (73%) were uniformly solid. Five malignant teratomas (45% overall and 71% of high-grade subtypes) had branching isoechoic components. Only 2 benign teratomas (1%) had isoechoic components that branched.


CONCLUSIONS
The presence of a branching isoechoic component in a cystic ovarian teratoma may suggest malignancy.
Mlikotic
A
A
Department of Radiology, Harbor-UCLA Medical Center, Torrance, California, USA.
McPhaul
L
L
Hansen
G C
GC
Sinow
R M
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography