ARRS 2022 Abstracts

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1120. Pubic Cartilaginous Cysts: MRI and CT Imaging Characteristics
Authors * Denotes Presenting Author
  1. Roman Shrestha *; Mayo Clinic Arizona
  2. Jeremiah Long; Mayo Clinic Arizona
  3. Jonathan Flug; Mayo Clinic Arizona
  4. Michael Fox; Mayo Clinic Arizona
  5. Mark Kransdorf; Mayo Clinic Arizona
Objective:
This study aims to describe the clinical features and imaging characteristics of pubic cartilaginous cysts in eight pathologically proven cases.

Materials and Methods:
Eight pathologically proven pubic cartilaginous cysts in six patients (two patients each had two cysts) were collected at our institution. Their clinical presentations and imaging findings were retrospectively reviewed. All six patients had MRI without and with gadolinium intravenous contrast available, and four had CT imaging available. We evaluated clinical information, lesion size, and morphology along with MRI and CT imaging characteristics and assessment of the pubic symphysis.

Results:
Although uncommon, pubic cartilaginous cysts occur in a distinctive location (in direct contact with the pubic symphysis), often in a specific demographic (postmenopausal, multiparous women) and have a highly characteristic imaging appearance (a rounded cyst-like mass showing a “keyhole” sign enhancement pattern). When present, imaging features of this entity should allow for an unequivocal imaging diagnosis. A pubic cartilaginous cyst is a highly uncommon benign tumor. Given the rarity of this entity, an interpreting radiologist may be perplexed when confronted by this tumor in practice, potentially leading to confusion with a more sinister process and prompting unnecessary additional imaging or intervention. Awareness of this entity is important for radiologists, as the symphysis pubis is included on many different imaging studies performed and interpreted by many imaging subspecialists.

Conclusion:
Although uncommon, pubic cartilaginous cysts occur in a distinctive location (in direct contact with the pubic symphysis), often in a specific demographic (postmenopausal, multiparous women) and have a highly characteristic imaging appearance (a rounded cyst-like mass showing a “keyhole sign” enhancement pattern). When present, imaging features of this entity should allow for an unequivocal imaging diagnosis. A pubic cartilaginous cyst is a highly uncommon benign tumor. Given the rarity of this entity, an interpreting radiologist may be perplexed when confronted by this tumor in practice, potentially leading to confusion with a more sinister process and prompting unnecessary additional imaging or intervention. Awareness of this entity is important for radiologists as the symphysis pubis is included on many different imaging studies performed and interpreted by many imaging subspecialists.