MDCT in Management of Ovarian Masses

Ovarian tumors are epithelial, mesenchymal, mixed epithelial and mesenchymal, sex stromal and germ cell tumors. Serous and mucinous cystadenoma and adenocarcinoma are differentiated by larger solid component, papillary projections and thick enhancing septae. Serous cyst adenomas and carcinomas are usually bilateral and have more papillary projections as opposed to mucinous neoplasms (usually unilateral and papillary projections are less marked). CT is the modality for staging. Adjacent pelvic organ involvement may be difficult to diagnose accurately. In a large ovarian tumour, it may be difficult to identify uterus which is partially or completely surrounded by tumour. Focal obliteration of fat plane or tumour encasement of bladder or recto-sigmoid is highly suspicious of involvement of the structures Pelvic side wall invasion is suspected when tumour lies within 3mm of pelvic side wall or when iliac vessel is surrounded or displaced by tumour. Teratomas are having solid, cystic, fat component and calcification. Brenner’s tumor is detected incidentally. Sex cord sclerosing stromal tumors are unilateral and may be hormonally active. Krukenberg metastases are solid and bilateral.