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Borderline Tumors of the Ovary: CT and MRI Features and Tumor Markers in Differentiation from Stage I Disease

Nandita M. deSouza1,2, Richard O'Neill1, G. Angus McIndoe3, Roberto Dina4 and W. Patrick Soutter3

1 Department of Imaging, Hammersmith Hospital, DuCane Rd., London W12 0HS, England.
2 Present address: Section of Magnetic Resonance Imaging, Institute of Cancer Research, Royal Marsden Hospital, Downs Rd., Sutton, Surrey SM2 5PT, England.
3 Department of Gynaecological Oncology, Hammersmith Hospital, London W12 0HS, England.
4 Department of Histopathology, Hammersmith Hospital, London W12 0HS, England.



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  		Fig. 1A. —27-year-old woman with borderline ovarian cancer. Sagittal (A) and transverse (B) T2-weighted fast spin-echo images (TR/effective TE, 4,500/90 msec) show large multicystic mass (solid arrows) with fine, nodular solid components (arrowheads). Normal ovarian tissue (open arrow, A) is seen posteriorly. In A, A = anterior, P = posterior.

 


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  		Fig. 1B. —27-year-old woman with borderline ovarian cancer. Sagittal (A) and transverse (B) T2-weighted fast spin-echo images (TR/effective TE, 4,500/90 msec) show large multicystic mass (solid arrows) with fine, nodular solid components (arrowheads). Normal ovarian tissue (open arrow, A) is seen posteriorly. In A, A = anterior, P = posterior.

 


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  		Fig. 1C. —27-year-old woman with borderline ovarian cancer. Photomicrograph shows histopathologic confirmation of borderline serous tumor, with micropapillation, lined by moderately atypical epithelium (arrow). (H and E, x100)

 


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  		Fig. 1D. —27-year-old woman with borderline ovarian cancer. Photomicrograph of histopathologic specimen obtained at high power (x400) reveals areas of cellular crowding with loss of cohesiveness. (H and E)

 


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  		Fig. 2. —MDCT scan obtained through mid pelvis of 81-year-old woman with borderline ovarian tumor shows well-defined heterogeneous mass (arrow) with multiple thickened septations (arrowhead). Bladder (BL) is seen anteriorly.

 


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  		Fig. 3A. —77-year-old woman with stage I ovarian tumor. Sagittal (A) and transverse (B) T2-weighted fast spin-echo images (TR/effective TE, 4,500/90 msec) show well-defined heterogeneous mass (arrow). Hemorrhage within cystic component contributes to its low signal-intensity on T2-weighting. Florid large nodules and vegetations (arrowheads) are seen posteriorly. Uterus and cervix (open arrow, B) are normal. In A, A = anterior, P = posterior.

 


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  		Fig. 3B. —77-year-old woman with stage I ovarian tumor. Sagittal (A) and transverse (B) T2-weighted fast spin-echo images (TR/effective TE, 4,500/90 msec) show well-defined heterogeneous mass (arrow). Hemorrhage within cystic component contributes to its low signal-intensity on T2-weighting. Florid large nodules and vegetations (arrowheads) are seen posteriorly. Uterus and cervix (open arrow, B) are normal. In A, A = anterior, P = posterior.

 


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  		Fig. 3C. —77-year-old woman with stage I ovarian tumor. Photomicrograph of histopathologic specimen shows serous papillary carcinoma with papillary formations that form solid nodule (arrows) within a cystic area. (H and E, x100)

 


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  		Fig. 3D. —77-year-old woman with stage I ovarian tumor. Photomicrograph of histopathologic specimen obtained at high power (x400) shows tumor islands within stroma (arrow) that confirm invasive nature of lesion. (H and E)

 


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  		Fig. 4. —MDCT scan obtained through mid pelvis of 51-year-old woman with stage I ovarian tumor shows well-defined mass (solid arrow) of heterogeneous density with large nodular solid components (arrowhead). Small amount of ascites (open arrow) is seen.

 

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