The growing teratoma syndrome secondary to immature teratoma of the ovary

Ohne Zusammenfassung     

Cystic teratoma of the ovary: CT detection

Computed tomography (CT) was performed in 38 patients with 41 benign cystic teratomas of the ovary and two patients with malignant transformation. CT depicted all tumors. The presence of fat in 40 of 43 cases (93%), tooth or calcification in 24 of 43 (56%), Rokitansky protuberance in 35 of 43 (81%), tufts of hair in 28 of 43 (65%), and a fat-fluid level in five of 43 (12%) allowed a definite diagnosis of ovarian cystic teratoma in 42 of 43 cases (98%). In the two cases of malignancy, single large (greater than 10 cm) plugs (with uptake of contrast medium in one) with a cauliflower appearance and an irregular border forming an obtuse angle with the inner wall of the cyst suggested malignant transformation. In three cases of benign cystic teratoma, a mucinous tumor (one benign, one borderline, one malignant) arising in the same ovary was seen at pathologic examination but was only diagnosed with the help of CT in two of three cases. Thickening of the tube was noted in two cases of torsion of the adnexa. CT findings were compared with findings at radiography of the abdomen and hysterosalpingography in 30 cases, ultrasound in 31, and magnetic resonance imaging in three. This study demonstrated that CT was the best procedure for imaging cystic teratomas of the ovary.     

Direct multiplanar CT findings in cystic teratoma of the ovary

The CT findings in cystic teratomas of the ovary are reviewed and our findings in four patients discussed. We analyzed those teratomas with standard CT, augmented by direct nonreconstructed coronal and sagittal views, to establish the true extent of the process and to define the characteristic heterogeneous contents. Computed tomography was successful in predicting or excluding malignant degeneration.     

CT features of torsion of benign cystic teratoma of the ovary

PURPOSE: The purpose of this work was to evaluate the usefulness of CT scans for distinguishing torsed from uncomplicated benign cystic teratoma (BCT). METHOD: Retrospective analysis was performed in 14 torsed BCTs (14 patients) and in 23 uncomplicated BCTs (20 patients) for comparison. The features on CT scans were compared to the pathologic findings. RESULTS: CT findings indicating torsed BCT were the presence of eccentric wall thickening of >1 cm, peritumoral infiltration, and presence of enlarged solid tubal mass adjacent to the uterus (p < 0.05). CONCLUSION: The present study suggests that CT is useful in differentiating torsed from uncomplicated BCT. Although CT findings are not specific for some patients, detection of certain CT findings could increase the diagnostic accuracy.     

Granulosa cell tumor of the ovary: common findings and unusual appearances on CT and MR

PURPOSE: The purpose of this article was to demonstrate CT and MR findings of granulosa cell tumor of the ovary. METHODS: MR (n = 7) and CT (n = 6) images of 11 tumors were analyzed. Uterine changes were also assessed. RESULTS: Multiseptated cystic mass (n = 4; mean, 14.5 cm) and unlobulated solid mass with internal cysts (n = 4; mean, 5.3 cm) were two common forms. Hemorrhage was found in five on MRI. Three tumors showed unusual appearances (an unilocular cystic mass, a lobulated solid mass with nonhemorrhagic cysts, and an entirely solid mass) and were not accompanied by any abnormal uterine changes, whereas all the tumors of common forms were associated with uterine changes explainable by hormonal stimuli in the postmenopausal patients. CONCLUSIONS: Large multiseptated cystic mass and medium solid mass with internal cysts were two common forms. Hemorrhage was a common MR finding. Uterine changes were frequently associated with the tumors with these common findings.     

Congenital maturing immature intraventricular teratoma

We report a case of a maturing immature intraventricular teratoma in a neonate. The computed tomography and magnetic resonance imaging and pathologic findings are described. The relevant literature is reviewed and management is discussed.     

Chemoradiotherapy for neurohypophyseal immature teratoma

We performed chemoradiotherapy for two patients (aged 6 and 33 years)with neurohypophyseal immature teratoma. The patients received total doses of 40 to 50.6 Gy with concurrent carboplatin and etoposide. In both cases, neurological symptoms improved. Both patients are still alive and remain free from local recurrence and distant metastasis 92 months and 62 months, respectively, after the completion of chemoradiotherapy. No late complications were observed. Chemoradiotherapy is extremely effective in the treatment of neurohypophyseal immature teratoma.     

卵巢未成熟畸胎瘤肝转移1例

患者　女 ,2 0岁。未婚。腹胀 ,便秘 2周 ,月经规律 ,无发热 ,恶心及呕吐。查体 :下腹膨隆 ,下腹耻骨上可触及 12cm× 15cm大小包块 ,质的偏实性 ,无压痛 ,活动度差 ,叩诊移动性浊音 (+) ,肠音亢进 12次 /min ,肛腹诊 :子宫后方触及肿块 ,活动差 ,直肠子宫凹液体 (+)。B超示 :下腹强、低或无混杂回声肿块 ,边界清 ,彩色多普勒示周边血流丰富。CT平扫见子宫右前方一 8cm× 12cm× 17cm肿块 ,包膜完整 ,类卵圆形 ,内密度不均 ,可见实性区 ,散在囊性区及斑片样钙化影 (图 1) ,CT值 - 70HU～ 2 6 0HU ,边缘清晰 ,子宫及肠管受压移位 ,强化扫…     

Malignant involvement of the iliopsoas muscle: CT appearances

Computed tomography has led to an increase in recognition of psoas pathology in general and malignant involvement in particular. A series of 25 cases of malignant involvement of the iliopsoas is presented. The wide spectrum of malignant tumours which can invade the psoas and the diversity of CT appearances are described. In particular, it is shown that involvement is frequently extensive, a feature which has not been previously emphasised.     

胸部结节病的CT表现

目的:探讨CT诊断胸部结节病的影像学表现。方法:回顾性分析经临床和病理证实并在治疗前后均进行CT检查的20例胸部结节病的CT征象。结果:20例均可见胸部淋巴结增大,其中14例有广泛的纵隔和对称性肺门淋巴结肿大;4例纵隔和单侧淋巴结肿大;2例可见纵隔淋巴结肿大。13例出现肺部病(包括9例肺内多发结节,3例斑片状融合块影,1例肺纤维化);1例胸膜病变。结论:结节病的胸部平片及临床表现缺乏特异性,CT对胸部结节病的诊断及鉴别诊断有一定的价值。     

Mediastinal myelolipoma: CT and MRI appearances

A 72-year-old man presented with a mediastinal mass on chest radiograph. Computed tomography and MR imaging showed that the mass consisted of both fatty and small nodular soft tissue components, highly suggestive of an extramedullary hematopoiesis or a myelolipoma. A CT-guided needle biopsy was next performed and confirmed the diagnosis. We discuss the CT and MR imaging appearances of this tumor and usefulness of a CT-guided needle biopsy to avoid surgery in asymptomatic patients. Received: 8 March 1999; Revised: 23 June 1999; Accepted: 25 June 1999     

Costal pleura: appearances at high-resolution CT

The appearance of the costal pleura at high-resolution computed tomography (CT) was evaluated with a cadaver and 25 normal subjects. This was contrasted with the high-resolution CT appearance of the costal pleura in 15 patients with mild pleural thickening, 13 of whom had been exposed to asbestos. On high-resolution CT scans in the normal subjects, a 1-2-mm-thick line of soft-tissue attenuation at the point of contact between lung and chest wall represents the visceral and parietal pleura, pleural contents, endothoracic fascia, and innermost intercostal muscle. In a paravertebral location, the innermost intercostal muscle is lacking, and a thin line seen on high-resolution CT scans reflects pleura and endothoracic fascia. Transverse thoracic and subcostal muscles and extrapleural fat pads can be seen as tissue internal to a rib and may be confused with pleural thickening. In 13 of the 15 patients with mild pleural thickening, the 1-3-mm-thick pleura was separable from the underlying normal intercostal muscle by a layer of extrapleural fat. High-resolution CT was more sensitive than CT with 1-cm collimation in depicting this degree of pleural abnormality.     

Cerebral cryptococcosis: atypical appearances on CT

Cryptococcal infection is common in immunocompromised patients, often presenting with meningitis or meningoencephalitis. We report an unusual presentation of cryptococcal infection in an immunocompetent patient presenting with headache and hemiplegia. CT demonstrated a large ring-enhancing lesion in the parietal region with intralesional calcification.     

High-grade immature teratoma of the testis in infancy.

Teratomas of the testis in infants are rare tumors which often display immature elements, disturbing in their histologic appearance. Although the presence of similar histologic features worsens prognosis in testicular teratomas in adults and in teratomas of infants and children presenting at other anatomic sites, the presence of immature elements in testicular teratomas of infancy does not appear to affect prognosis. Therefore, orchiectomy alone is adequate therapy for these neoplasms. The case of an 8-month-old infant with a teratoma of testis is presented.     

CT appearances of abdominal tuberculosis

The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.     

CT appearances of talc pleurodesis

AIM: To report the computed tomography (CT) appearances of talc pleurodesis in the management of patients with pleural effusions and spontaneous pneumothorax. MATERIALS AND METHODS: The post-pleurodesis CT studies of 16 patients obtained over a 5-year period were reviewed. The mean age was 63 years (range 41-79 years). Ten patients were male. After pleurodesis, nine patients underwent a single chest CT examination and seven patients underwent more than one. RESULTS: The characteristic finding observed in all patients, except one, was the presence of high-density deposits in the posterior basal regions of the pleural space. These were typically linear in seven patients, nodular in two, and a combination of linear and nodular in six. In five patients talc deposits were present on both the visceral and parietal pleura separated by an effusion (a variant of the split pleura sign). Talc deposits extended into an interlobar fissure with associated fissural thickening in five patients. In patients who underwent more than one CT study, the appearances remained stable. CONCLUSIONS: The typical finding was the presence of high attenuation areas in the posterior basal regions of the pleural space. Two new appearances were observed: extension of talc deposits into the fissure and the presence of a variant of the split pleura sign. It is important to recognize these CT appearances so as not to confuse them with other conditions such as asbestos exposure.