E2223. Ovary and Out: A Comprehensive Approach to Gynecologic Lesions
  1. Quinn Cottone; University of Mississippi Medical Center
  2. Chanukya Cherukuri; University of Mississippi Medical Center
  3. Aubrey Smyly; University of Mississippi Medical Center
  4. Richard Covington; University of Mississippi Medical Center
  5. Anna McCoy; University of Mississippi Medical Center
  6. Elliot Varney; University of Mississippi Medical Center
  7. Candace Howard; University of Mississippi Medical Center
Ovarian cancer is a prevalent cancer in women worldwide, totaling 3.6% of all cancer cases, with no significant statistical change in its survival rate over the past few years. Therefore, the accurate differentiation and diagnoses of adnexal masses is growingly important. Unfortunately, identifying adnexal masses is difficult, and the majority of them are benign, rather than malignant. A systematic approach involving multiple imaging modalities could prove to be beneficial in accurately and efficiently identifying various adnexal masses.

Educational Goals / Teaching Points
In this exhibit, we will discuss the strengths and weaknesses of various imaging modalities, such as US, CT, and MRI, pertaining to differentiating unidentified gynecologic masses. We will provide images with examples of both malignant and benign masses from previous cases. Additionally, we will establish an efficient and feasible approach to next-step imaging for various gynecologic masses.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
There are three types of primary ovarian neoplasms: epithelial, germ cell, and sex cord-stromal tumors, with epithelial being the most common. Furthermore, each of these tumors has numerous subtypes, adding to the confusion. Tumors can also present as low-risk, high-risk, benign, borderline, and malignant, with their differences on radiographic imaging being very subtle. Annotated case-studies of unique tumors and masses will be provided to demonstrate those differences, and imaging protocols to diagnose them will be discussed.

Radiologists should be knowledgeable on the various pathologies and characteristics of ovarian/gynecologic masses in order to accurately provide a diagnosis. Deriving a multimodal imaging approach, individualized to each adnexal tumor species, is a strong step forward in assisting that cause.