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Ovarian serous cystadenoma

An ovarian serous cystadenoma (OSC) is a type of benign ovarian epithelial tumour. It falls under the sub-group of ovarian serous tumours.

Epidemiology

Serous cystadenomas account for ~ 60% of ovarian serous tumours 1. They are the commonest type of ovarian epithelial neoplasm. The peak incidence is at ~ the 4th to 5th decades of life.

Pathology

Serous cystadenomas are usually composed of unilocular (or at times multilocular) cysts filled with clear watery fluid. The lining of the cyst is flat or may contain small papillary projections. As with other serous tumours, psammomatous calcification can be a feature.

Location

They can be bilateral in ~ 15 % of cases.

Radiographic features

Ultrasound

Usually seen as a unilocular cystic adnexal lesion. Papillary projections are usually absent and if present tends to be thin, have an acute angle with the cyst wall and have a regular surface 5. Some lesions may contain sonographically detectable septations.

CT

Often seen as a unilocular (typically) or multilocular cystic mass with homogeneous CT attenuation , with a thin regular wall or septum, and usually no endocystic or exocystic vegetation 1,4.  Cysts can be quite large in size and have the potential to be seen filling most of the lower pelvis with extension into the upper abdomen.

MRI

The typical MR imaging appearance of serous cystadenoma is as a unilocular thin walled adnexal cyst 2. MRI may show a beak sign which may suggest an ovarian origin.

Signal characteristics within the cyst are usually homogeneous.

  • T1 - cyst content is usually of low signal in uncomplicated cases
  • T2 - cyst content is of fluid (high) signal

Treatment and prognosis

They are benign lesions usually with a good prognosis. More content required

Differential diagnosis

General imaging differential consderations include

See also

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