Utility of the "floating ball sign" in diagnosis of ovarian cystic teratoma/Over kistik teratoma tanisinda "yuzen top isaretinin" yararliligi

• Published in: Turkish journal of obstetrics and gynecology Vol. 16; no. 2; p. 118
• Main Authors: Sahin, Hilal, Akdogan, Asli Irmak, Ayaz, Duygu, Karadeniz, Tugba, Sanci, Muzaffer
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.06.2019
• Subjects: Carcinoma; CAT scans; Diagnosis; Diagnostic imaging; Regression analysis; Squamous cell carcinoma; Teratoma; Tomography; Tumors; Women
• ISSN: 2149-9322
• DOI: 10.4274/tjod.galenos.2019.67209

Objective: To evaluate the incidence of the "floating ball" sign in cross-sectional imaging modalities in patients with ovarian teratoma, and to investigate the relationship between the morphologic features of the teratoma and this sign. Materials and Methods: Preoperative computed tomography and magnetic resonance imaging studies of 112 women with a pathologic diagnosis of ovarian mature cystic teratoma (MCT) were reviewed for the presence of the floating ball sign. Tumor size, tumor characteristics and the number, size, and characteristics of floating globules were evaluated. Results: In 112 patients (mean age 35.5[+ or -]16 years, range 5-84 years), 118 ovarian MCTs were diagnosed pathologically The floating ball sign was demonstrated in cross-sectional imaging in 30 (25.4%) patients. Among 2 of them, MCT was associated with malignancy (squamous cell carcinoma). There was a significant relationship between the floating ball sign, tumor size, and the wall thickness of the tumor (p=0.003 and p=0.018, respectively). In linear regression analysis, a similarly significant relationship was found between the presence of this sign and tumor size and patient age (p=0.003 and p=0.035, respectively). Conclusion: The floating ball sign, as a pathognomonic sign for the diagnosis of ovarian teratomas, seems to be more common than is known. Although this sign is almost always seen in MCTs, it may rarely be seen in teratomas with malignant transformation. The relationship of this sign with the characteristics of the tumor can provide an insight into the occurrence of these balls. Keywords: Dermoid cyst, magnetic resonance imaging, tomography, ovary Amac: Over teratomlu hastalarda kesitsel goruntuleme modalitelerinde "yuzen top" isaretinin sikligini degerlendirmek ve teratomun morfolojik ozellikleri ile bu isaret arasindaki iliskiyi saptamaktir Gerec ve Yontemler: Patolojik olarak over matur kistik teratoma (MKT) tanisi alan 112 kadin hastanin bilgisayarli tomografi ve manyetik rezonans goruntuleme calismalari yuzen top isareti varligi acisindan degerlendirildi. Tumor boyutu, tumor karakteristikleri ve yuzen globullerin sayi, boyut ve karakteristikleri degerlendirildi. Bulgular: Yuz on iki hastada (ortalama yas 35,5[+ or -]16, yas araligi 5-84), patolojik tani alan 118 over MKT degerlendirildi. Kesitsel goruntuleme yontemleri ile yuzen top isareti 30 hastada (%25,4) saptandi. Bu hastalarin 2'sinde MKT malignite ile birlikte idi (skuamoz hucreli karsinoma). Yuzen top isareti ile tumor boyutu ve tumor duvar kalinligi arasinda anlamli iliski saptandi (sirasiyla p=0,003 ve p=0,018). Lineer regresyon analizinde, benzer sekilde yuzen top isareti varligi ile tumor boyutu ve hasta yasi arasinda anlamli iliski saptandi (sirasiyla p=0,003 ve p=0,035). Sonuc: Yuzen top isareti over teratomu tanisinda patognomonik bir bulgu olup bilinenden daha sik gorulmektedir. Bu isaret neredeyse tamamen MKTde gorulmekle birlikte nadiren malign transformasyon gosteren teratomlarda da gorulebilmektedir. Bu bulgunun tumor karakteristikleri ile olan iliskisi yuzen toplarin olusumu hakkinda bilgi verebilir. Anahtar Kelimeler: Dermoid kist, manyetik rezonans goruntuleme, tomografi, over