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dc.creatorAnfelter, P. (P.)-
dc.creatorTesta, A.C. (Antonia Carla)-
dc.creatorChiappa, V. (Valentina)-
dc.creatorFroyman, W. (Wouter)-
dc.creatorFruscio, R. (Robert)-
dc.creatorGuerriero, S. (Stefano)-
dc.creatorAlcazar, J.L. (Juan Luis)-
dc.creatorMascillini, F. (F.)-
dc.creatorPascual, M.A. (Maria Angela)-
dc.creatorSibal, M. (M)-
dc.creatorSavelli, L. (L.)-
dc.creatorZannoni, G.F. (G.F.)-
dc.creatorTimmerman, D. (Dirk)-
dc.creatorEpstein, E. (E.)-
dc.identifier.citationAnfelter, P. (P.); Testa, A. (A.); Chiappa, V. (V.); et al. "Imaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors)". Ultrasound in Obstetrics & Gynecology. 56 (2), 2020, 276 - 284es
dc.description.abstractObjective To describe the clinical and sonographic characteristics of malignant ovarian yolk sac tumors (YSTs). Methods In this retrospective multicenter study, we included 21 patients with a histological diagnosis of ovarian YST and available transvaginal ultrasound images and/or videoclips and/or a detailed ultrasound report. Ten patients identified from the International Results All cases were pure YSTs, except for one that was a mixed tumor (80% YST and 20% embryonal carcinoma). Median age at diagnosis was 25 (interquartile range (IQR), 19.5–30.5) years. Seventy-six percent (16/21) of women had an International Federation of Gynecology and Obstetrics (FIGO) Stage I–II tumor at diagnosis. Fifty-eight percent (11/19) of women felt pain during the ultrasound examination and one presented with ovarian torsion. Median serum α-fetoprotein (S-AFP) level was 4755 (IQR, 1071–25 303) μg/L and median serum CA 125 level was 126 (IQR, 35–227) kU/L. On ultrasound assessment, 95% (20/21) of tumors were unilateral. The median maximum tumor diameter was 157 (IQR, 107–181) mm and the largest solid component was 110 (IQR, 66–159) mm. Tumors were classified as either multilocular-solid (10/21; 48%) or solid (11/21; 52%). Papillary projections were found in 10% (2/21) of cases. Most (20/21; 95%) tumors were well vascularized (color score, 3–4) and none had acoustic shadowing. Malignancy was suspected in all cases, except in the patient with ovarian torsion, who presented a tumor with a color score of 1, which was classified as probably benign. Image and videoclip quality was considered as adequate in 18/21 cases. On review of the images and videoclips, we found that all tumors contained both solid components and cystic spaces, and that 89% (16/18) had irregular, still fine-textured and slightly hyperechoic solid tissue, giving them a characteristic appearance. Conclusion Malignant ovarian YSTs are often detected at an early stage, in young women usually in the second or third decade of life, presenting with pain and markedly elevated S-AFP. On ultrasound, malignant ovarian YSTs are mostly unilateral, large and multilocular-solid or solid, with fine-textured slightly hyperechoic solid tissue and rich vascularization. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.es_ES
dc.description.sponsorshipThis study was supported by ALF Grant (20160101-563101), by Stockholm County Council and Radiumhemmets research funds (grant: 154112).es_ES
dc.subjectEndodermal sinus tumores_ES
dc.subjectMalignant germ-cell tumores_ES
dc.subjectUltrasound featureses_ES
dc.subjectYolk sac tumores_ES
dc.titleImaging in gynecological disease (17): ultrasound features of malignant ovarian yolk sac tumors (endodermal sinus tumors)es_ES
dc.description.noteThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.es_ES
dadun.citation.publicationNameUltrasound in Obstetrics & Gynecologyes_ES

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