卵巣腫瘍で腹腔鏡下手術を施行し、境界悪性腫瘍と診断された症例の術前MRI評価について

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Background; MR images are considered to be highly effective to examine ovarian tumors. However, in some case, it is difficult to differentiate malignant ovarian tumors from benign ones.Methods; Five hundred eighty-nine cases of ovarian tumors were managed by laparoscopic surgery during a period of six years. Of these cases, 15 cases were diagnosed as borderline ovarian tumors after surgery, and MR images of these cases were retrospectively reviewed.Results; The mean age was 35 years old and the mean follow-up period was 36 months. Pathological results revealed ten cases of mucinous borderline tumors (67%), three cases of serous borderline tumors (20%), and the other two cases. In reviewing preoperative MR images, six cases showed solid parts within the tumor walls enhanced by contrast agents or huge tumor size (over 20 cm in diameter). Of ten cases of pathologically proven mucinous borderline tumors, five cases were interpreted as endometrial cysts before surgery.Conclusion; For the gynecologic laparoscopists, it is necessary to thoroughly understand the characteristic features of MR images for ovarian tumors. If MR images show any possibility of malignancy, proper strategies such as frozen section diagnosis should be considered.
日本産科婦人科内視鏡学会の論文
2009-09-01