Diagnosis of Ovarian Metastasis from Gestational Trophoblastic Neoplasia by 3D Power Doppler Ultrasound

Diagnosis of Ovarian Metastasis from Gestational Trophoblastic Neoplasia by 3D Power Doppler Ultrasound and Dynamic Contrast-Enhanced Magnetic Resonance Imaging: Case Report

Article (PDF Available) in Case Reports in Oncology 5(2):359-66 · July 2012 with 138 Reads

DOI: 10.1159/000341256 · Source: PubMed

Cite this publication

Edward Araujo Júnior

46.5Universidade Federal de São Paulo

S.Y. Sun

  • 4

Felipe Favorette Campanharo

14.84Universidade Federal de São Paulo

Daniela Nacaratto

4.21Universidade Federal de São Paulo

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Abstract

Choriocarcinoma is a highly malignant disease of trophoblastic cells, which affects young women in the reproductive years. The main sites of metastasis from choriocarcinoma are lung, vagina, liver, gastrointestinal tract and kidneys, and the involvement of the ovaries is extremely rare. The diagnosis of ovarian metastasis is made mainly by two-dimensional ultrasonography (2DUS) with color Doppler, which shows a large vessel in the center of the mass. The three-dimensional power Doppler ultrasound (3D power Doppler) and dynamic contrast-enhanced magnetic resonance imaging (MRI) are new diagnostic modalities not yet published in literature. We report a case of metastatic choriocarcinoma with left ovary involvement in a 48-year-old woman with history of molar pregnancy and irregular follow-up of this disease. We emphasize the main findings by 2DUS with color Doppler, 3D power Doppler and dynamic contrast-enhanced MRI. 3D power Doppler is able to improve the assessment of anatomical relationships of vessels with the ovarian mass, while the resonance angiography allows us to evaluate the anatomic relations of the mass and adjacent structures, as well as the iliac vessels. The 3D power Doppler and dynamic contrast-enhanced MRI are promising methods in the evaluation of metastasis arising from gestational trophoblastic tumors…

a Measurement of ovarian tumor by 2DUS. b 2DUS with color Doppler showing the ‘lead vessel’, and spectral Doppler proving the low indices of resistance (pulsatiliy and resistance indices) of ovarian tumor vascularization.

a, b 3D power Doppler showing the high vascularization of ovarian tumor

a MRI in T2-weighted sequence in sagittal plane showing the relationship of ovarian tumor with adjacent structures. b MRI with paramagnetic contrast (dynamic contrast-enhanced MRI) showing the vascularization of ovarian tumor and its relationships with iliac vessels.

CT in axial plane after intravenous contrast of abdomen showing the metastasis (hyperechoic lesions) to liver (a), lung (b) and kidneys ©.