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The differential imaging features of fat-containing tumors in the peritoneal cavity and retroperitoneum: the radiologic-pathologic correlation.

Shin NY, Kim MJ, Chung JJ, Chung YE, Choi JY, Park YN - Korean J Radiol (2010)

Bottom Line: At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques.Thus, the questions about the treatment methods have become increasingly important.Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.

ABSTRACT
There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson's capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

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Related in: MedlinePlus

19-year-old woman with mature cystic teratoma.A. On axial contrast-enhanced CT scan, well-encapsulated, multiloculated cystic and solid lesion shows fat-attenuation (arrow) with calcifications (open arrow).B, C. Heterogeneous internal signal intensity nodule on axial T2-weighted MR image (B) shows signal loss on axial fat-saturated T2-weighted MR image (C), and this represents fat component (arrows).
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Figure 10: 19-year-old woman with mature cystic teratoma.A. On axial contrast-enhanced CT scan, well-encapsulated, multiloculated cystic and solid lesion shows fat-attenuation (arrow) with calcifications (open arrow).B, C. Heterogeneous internal signal intensity nodule on axial T2-weighted MR image (B) shows signal loss on axial fat-saturated T2-weighted MR image (C), and this represents fat component (arrows).

Mentions: Although mature cystic teratomas show various appearances on US, most can be characterized by the presence of echogenic sebaceous material and calcification. When there is fat attenuation within a cyst on CT, with or without calcification in the wall, it is diagnostic of mature cystic teratoma. On MR imaging, the fat-suppressed images can specifically identify the sebaceous component (Fig. 10). The typical US appearances are heterogeneous, partially solid lesions, usually with scattered calcifications, although these are non-specific for immature teratomas. Both CT and MR imaging show the characteristic appearance of immature teratoma as a large, irregular solid component containing coarse calcifications. Small foci of fat also help characterize these tumors, and hemorrhage is often present. The US features of struma ovarii are also nonspecific, but a complex appearance with multiple cystic and solid areas may be seen. The cystic spaces demonstrate both high and low signal intensity on the T1- and T2-weighted images. On both the T1- and T2-weighted images, some of the cystic spaces may demonstrate low signal intensity due to the thick, gelatinous colloid of the struma. Fat is not evident in these lesions (28).


The differential imaging features of fat-containing tumors in the peritoneal cavity and retroperitoneum: the radiologic-pathologic correlation.

Shin NY, Kim MJ, Chung JJ, Chung YE, Choi JY, Park YN - Korean J Radiol (2010)

19-year-old woman with mature cystic teratoma.A. On axial contrast-enhanced CT scan, well-encapsulated, multiloculated cystic and solid lesion shows fat-attenuation (arrow) with calcifications (open arrow).B, C. Heterogeneous internal signal intensity nodule on axial T2-weighted MR image (B) shows signal loss on axial fat-saturated T2-weighted MR image (C), and this represents fat component (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864861&req=5

Figure 10: 19-year-old woman with mature cystic teratoma.A. On axial contrast-enhanced CT scan, well-encapsulated, multiloculated cystic and solid lesion shows fat-attenuation (arrow) with calcifications (open arrow).B, C. Heterogeneous internal signal intensity nodule on axial T2-weighted MR image (B) shows signal loss on axial fat-saturated T2-weighted MR image (C), and this represents fat component (arrows).
Mentions: Although mature cystic teratomas show various appearances on US, most can be characterized by the presence of echogenic sebaceous material and calcification. When there is fat attenuation within a cyst on CT, with or without calcification in the wall, it is diagnostic of mature cystic teratoma. On MR imaging, the fat-suppressed images can specifically identify the sebaceous component (Fig. 10). The typical US appearances are heterogeneous, partially solid lesions, usually with scattered calcifications, although these are non-specific for immature teratomas. Both CT and MR imaging show the characteristic appearance of immature teratoma as a large, irregular solid component containing coarse calcifications. Small foci of fat also help characterize these tumors, and hemorrhage is often present. The US features of struma ovarii are also nonspecific, but a complex appearance with multiple cystic and solid areas may be seen. The cystic spaces demonstrate both high and low signal intensity on the T1- and T2-weighted images. On both the T1- and T2-weighted images, some of the cystic spaces may demonstrate low signal intensity due to the thick, gelatinous colloid of the struma. Fat is not evident in these lesions (28).

Bottom Line: At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques.Thus, the questions about the treatment methods have become increasingly important.Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.

ABSTRACT
There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson's capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

Show MeSH
Related in: MedlinePlus