Journal of Ultrasound in Medicine, Vol 20, Issue 8 859-866, Copyright © 2001 by American Institute of Ultrasound in Medicine
Significance of the solid component in predicting malignancy in ovarian cystic teratomas: diagnostic considerations
A. Mlikotic, L. McPhaul, G. C. Hansen and R. M. Sinow
Department of Radiology, Harbor-UCLA Medical Center, Torrance, California, USA.
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.
