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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Ovarian-adnexal reporting and data system ultrasound evaluation and pathological characteristics of ovarian collision tumor
Chan Yin, Yong Wang, Zhi-Hui Fei, Li-Hong Sun, Wei-Ai Zhou, Heng Li
Chan Yin, Department of Ultrasound, Hunan University of Arts and Sciences Affiliated Changde Maternal and Child Health Hospital, Changde 415000, Hunan Province, China
Yong Wang, Department of Ultrasound, People's Hospital of Shimen County, Changde 415300, Hunan Province, China
Zhi-Hui Fei, Department of Ultrasound Medicine, The Maternal and Child Health Hospital of Changde, Changde 415000, Hunan Province, China
Li-Hong Sun, Department of Psychology, The Maternal and Child Health Hospital of Changde, Changde 415000, Hunan Province, China
Wei-Ai Zhou, Department of Gynaecology, Hunan University of Arts and Sciences Affiliated Changde Maternal and Child Health Hospital, Changde 415000, Hunan Province, China
Heng Li, Department of Ultrasound, The First People's Hospital of Changde, Changde 415000, Hunan Province, China
Co-first authors: Chan Yin and Yong Wang.
Co-corresponding authors: Wei-Ai Zhou and Heng Li.
Author contributions: Yin C contributed data analysis and manuscript writing; Wang Y contributed data management, manuscript writing; Fei ZH contributed data collection and manuscript editing; Zhou WA contributed project development and management; Li H contributed data collection and manuscript writing; All the author has read and approved the manuscript.
Supported by Hunan Provincial Natural Science Foundation Regional Joint Fund, No. 2023JJ50050.
Institutional review board statement: This study was approved by the Ethics Committee of the Maternal and Child Health Hospital of Changde City. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent statement: Written informed consent was obtained from the pregnant woman or patient’s parent for their personal or clinical details along with identifying images to be published in this study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Wei-Ai Zhou, MD, Chief Doctor, Department of Gynaecology, Hunan University of Arts and Sciences Affiliated Changde Maternal and Child Health Hospital, No. 1058 Dongting Avenue, Changde 415000, Hunan Province, China. cdfycsk@163.com
Received: March 14, 2024
Revised: June 5, 2024
Accepted: June 17, 2024
Published online: August 6, 2024
Processing time: 110 Days and 6.5 Hours
BACKGROUND
Collision tumor are neoplasms, including two histologically distinct tumors that coexist in the same mass without histological admixture. The incidence of collision tumor is low and is rare clinically.
AIM
To investigate ultrasound images and application of ovarian-adnexal reporting and data system (O-RADS) to evaluate the risk and pathological characteristics of ovarian collision tumor.
METHODS
This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023. All clinical features, ultrasound images and histopathological features were collected and analyzed. The O-RADS score was used for classification. The O-RADS score was determined by two senior doctors in the gynecological ultrasound group. Lesions with O-RADS score of 1-3 were classified as benign tumors, and lesions with O-RADS score of 4 or 5 were classified as malignant tumors.
RESULTS
There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery. The average age of 17 women with ovarian collision tumor was 36.7 years (range 20-68 years), in whom, one occurred bilaterally and the rest occurred unilaterally. The average tumor diameter was 10 cm, of which three were 2-5 cm, 11 were 5-10 cm, and three were > 10 cm. Five (29.4%) tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma, and unilocular or multilocular cysts contained a small number of parenchymal components. Eleven (64.7%) tumors had an O-RADS score of 4, including two in category 4A, six in category 4B, and three in category 4C; all of which were multilocular cystic tumors with solid components or multiple papillary components. One (5.9%) tumor had an O-RADS score of 5. This case was a solid mass, and a small amount of pelvic effusion was detected under ultrasound. The pathology was high-grade serous cystic cancer combined with cystic mature teratoma. There were nine (52.9%) tumors with elevated serum carbohydrate antigen (CA)125 and two (11.8%) with elevated serum CA19-9. Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common, which was different from previous results.
CONCLUSION
The ultrasound images of ovarian collision tumor have certain specificity, but diagnosis by preoperative ultrasound is difficult. The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor. The O-RADS score of ovarian collision tumor is mostly ≥ 4, which can sensitively detect malignant tumors.
Core Tip: The ultrasound image characteristics of ovarian collision tumor have certain specificity, which can be divided into three types, but preoperative ultrasound is still difficult to make a clear diagnosis; The combination of epithelial cell tumor and mesenchymal cell tumor is the most common type of ovarian collision tumor; The o-rads system can sensitively detect malignant tumors when the o-rads score of ovarian collision tumors is mostly 4 or above.
