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.
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.
They can be bilateral in ~15% of cases.
- usually seen as a unilocular cystic adnexal lesion
- papillary projections are absent
- if there is any wall irregularity, it is thin, with an acute angle with the cyst wall and has a regular surface 5
- some lesions may contain sonographically detectable septations.
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.
The typical MR imaging appearance of serous cystadenoma is 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 generally of hypointense signal in uncomplicated cases
- T2: cyst content is of fluid (hyperintense) signal
- T1 C + (Gd): enhancement of cyst wall sometimes occurs after contrast administration
Treatment and prognosis
They are benign lesions usually with a good prognosis. More content required
General imaging differential considerations include:
- ovarian cysts: for small lesions consider
- serous cystadenocarcinoma
- paraovarian cysts: no beak sign
- paraovarian cystadenoma: no beak sign
Ultrasound - gynaecology
- ultrasound (introduction)
- acute pelvic pain
- chronic pelvic pain
- Mullerian duct anomalies
- ovarian follicle
- ovarian torsion
- pelvic inflammatory disease
- ovarian cysts and masses
- ovarian cyst
- corpus luteum
- haemorrhagic ovarian cyst
- ruptured ovarian cyst
- ovarian epithelial tumours
- granulosa cell tumours of the ovary
- paraovarian cyst
- polycystic ovaries
- ovarian hyperstimulation syndrome
- post-hysterectomy ovary
- fallopian tube
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- 2. Imaoka I, Wada A, Kaji Y et-al. Developing an MR imaging strategy for diagnosis of ovarian masses. Radiographics. 26 (5): 1431-48. doi:10.1148/rg.265045206 - Pubmed citation
- 3. Buy JN, Ghossain MA, Sciot C et-al. Epithelial tumors of the ovary: CT findings and correlation with US. Radiology. 1991;178 (3): 811-8. Radiology (abstract) - Pubmed citation
- 4. Jeong YY, Outwater EK, Kang HK. Imaging evaluation of ovarian masses. Radiographics. 20 (5): 1445-70. Radiographics (full text) - Pubmed citation
- 5. Hassen K, Ghossain MA, Rousset P et-al. Characterization of papillary projections in benign versus borderline and malignant ovarian masses on conventional and color Doppler ultrasound. AJR Am J Roentgenol. 2011;196 (6): 1444-9. doi:10.2214/AJR.10.5014 - Pubmed citation
- 6. Kawamoto S, Urban BA, Fishman EK. CT of epithelial ovarian tumors. Radiographics. 1999;19 Spec No (suppl_1): S85-102. doi:10.1148/radiographics.19.suppl_1.g99oc10s85 - Pubmed citation
- 7. Ghossain MA, Buy JN, Lignères C et-al. Epithelial tumors of the ovary: comparison of MR and CT findings. Radiology. 1991;181 (3): 863-70. doi:10.1148/radiology.181.3.1947112 - Pubmed citation