title: Imaging of gynecological disease (6): clinical and ultrasound characteristics of ovarian dysgerminoma.
abstract: OBJECTIVE
  To describe the clinical history and ultrasound findings in patients with ovarian dysgerminoma.
  
  
  METHODS
  This was a retrospective study of patients with a histological diagnosis of ovarian dysgerminoma who had undergone preoperative ultrasound examination. The patients were identified from the databases of 11 ultrasound centers. The tumors were described by the principal investigator at each contributing center on the basis of ultrasound images, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. In addition, three authors reviewed all available electronic ultrasound images (gray-scale images and color/power Doppler images were available for 18 patients and 14 patients, respectively) and described them using subjective evaluation of gray-scale and color Doppler ultrasound findings (here called pattern recognition).
  
  
  RESULTS
  Twenty-one patients with ovarian dysgerminoma were identified (including one woman with bilateral masses). Twenty patients had a primary ovarian dysgerminoma (including the one with bilateral masses) and one patient had a recurrence of dysgerminoma in her retained ovary. One of the 21 patients was pregnant. All tumors except one were pure dysgerminomas, one being a mixed germinal cell tumor with 30% dysgerminoma component. Median age was 20 (range, 16-31) years. Information on clinical symptoms was available for 18 patients. In four patients, the tumor was detected incidentally, whereas 14 patients presented with one or more of the following symptoms: acute pain (n = 4), chronic pain (n = 8), bloating (n = 8), menstrual disorders (n = 5) and infertility problems (n = 1). One (5%) patient had ascites. Using the IOTA terms and definitions, all but one dysgerminoma were moderately (43%) or very well (50%) vascularized solid tumors. One tumor was multilocular-solid. According to pattern recognition, most dysgerminomas were highly vascularized, purely solid tumors with heterogeneous internal echogenicity divided into several lobules, had a smooth and sometimes lobulated contour and were well-defined relative to the surrounding organs.
  
  
  CONCLUSIONS
  The ultrasound finding of a highly vascularized, large, solid, lobulated adnexal mass with irregular internal echogenicity in a woman 20-30 years old should raise the suspicion of ovarian dysgerminoma.
authors.affiliation: Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy. gineca.sguerriero@tiscali.it
authors.forename: S
authors.initials: S
authors.lastname: Guerriero
authors.forename: A C
authors.initials: AC
authors.lastname: Testa
authors.forename: D
authors.initials: D
authors.lastname: Timmerman
authors.forename: C
authors.initials: C
authors.lastname: Van Holsbeke
authors.forename: S
authors.initials: S
authors.lastname: Ajossa
authors.forename: D
authors.initials: D
authors.lastname: Fischerova
authors.forename: D
authors.initials: D
authors.lastname: Franchi
authors.forename: F P G
authors.initials: FP
authors.lastname: Leone
authors.forename: E
authors.initials: E
authors.lastname: Domali
authors.forename: J L
authors.initials: JL
authors.lastname: Alcazar
authors.forename: G
authors.initials: G
authors.lastname: Parodo
authors.forename: F
authors.initials: F
authors.lastname: Mascilini
authors.forename: B
authors.initials: B
authors.lastname: Virgilio
authors.forename: V N
authors.initials: VN
authors.lastname: Demidov
authors.forename: J
authors.initials: J
authors.lastname: Lipatenkova
authors.forename: L
authors.initials: L
authors.lastname: Valentin
mesh_terms: D000293:Adolescent; D000328:Adult; D004407:Dysgerminoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult