Ovarian germ cell tumor CT

It is difficult to distinguish ovarian germ cell tumors on CT alone, however, pelvic/abdominal CT scan may be helpful in the diagnosis. Sensitive findings on CT scan for the diagnosis of mature teratoma include Fat attenuation, presence or absence of calcification in the cyst wall, palm-tree like protrusion, and fat–fluid levels. Presence of cauliflower appearance with irregular borders may warrant the necessity to search for malignant transformation of these tumors. CT scan findings characteristics of immature teratoma include A large, irregular solid mass, presence of coarse calcification, small foci of fat, and Hemorrhage. CT findings associated with other ovarian germ cell tumors are not specific, but may be helpful.

CT scan is a sensitive method to diagnose mature teratoma. Findings on CT scan suggestive of/diagnostic of mature teratoma include:^[1]

• Fat attenuation
• Presence or absence of calcification in the cyst wall
• Gravity dependent layering^[2]
• Palm-tree like protrusion
• Fat–fluid levels
• Whenever cauliflower appearance with irregular borders are observed, malignant transformation should be suspected.^[2]

CT scan findings of immature teratoma are characteristics and include:^[3]

• A large, irregular solid mass
• Presence of coarse calcification
• Small foci of fat
• Hemorrhage may also be present.

CT scan findings of dysgerminoma include:

• Lobulated pattern in the solid portion.^[4]
• Areas of septa which are enhnacing
• Areas of hemorrhage and necrosis which appear cystic
• Speckled pattern of calcification

CT scan findings of yolk sac tumor include:

• The bright dot sign (enhancing foci in the wall or solid component) is the common finding, although it is not the pathognomonic finding for the yolk sac tumor.^[4]
• Capsular tear is another common finding which is not the pathognomonic finding for the yolk sac tumor.

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