Purpose or Case Report: Learning objectives: This educational exhibit will review atypical ovarian neoplasms in the pediatric population. We will discuss the epidemiology, clinical presentation, multimodality imaging findings as seen on ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) of these rare adnexal entities.
Methods & Materials: Background: Although relatively rare in the pediatric population, ovarian neoplasms are the most common genital neoplasm occurring in childhood. These lesions may or may not be symptomatic and often may present as an incidental imaging findings. Atypical ovarian lesions, if not diagnosed and treated in a timely manner, may have significant impact on the patient’s fertility and can even be fatal. Therefore, recognition of their imaging appearance is of the utmost importance for the practicing radiologist. Imaging, in combination with tumor markers, has had a significant impact on management of ovarian neoplasms, allowing for more conservative approaches and positive outcomes.
Results: Imaging findings: We will review the imaging features of following atypical pediatric ovarian neoplasms using a multi-modality case based approach.
Primary:
Sex cord-stromal tumors
Germ cell tumors
Gonadoblastoma
Germ cell sex cord-stromal tumor of nongonadoblastoma type
Mesothelial tumors
Inflammatory myofibroblastic tumor
Gestational trophoblastic disease
Soft tissue tumors not specific to the ovaries
Lymphomas/Leukemias
Rhabdomyosarcoma
Secondary:
Metastatic tumors
Conclusions: Identifying and characterizing ovarian neoplasms in the pediatric population can be challenging and often presents a diagnostic dilemma. However, by using a multi-modality approach the pediatric radiologist can use key imaging features to elucidate the diagnosis and guide referring clinicians.