VP04.22: Use of ultrasound score systems in the study of malignant ovarian masses in premenopausal women

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To determine ultrasound (US) characteristics of malignant ovarian masses in premenopausal women using different US score systems. Retrospective analysis of malignant ovarian masses in women under 45 years old diagnosed of ovarian cancer (OC) during the last 10 years. Ultrasound score systems (IOTA simple rules, GI-RADS and Adnex model) were applied. 17 ovarian masses in 11 women with OC were reviewed. Mean age at diagnosis was 39.64 years (SD: 4.76; min:28, max: 44). Most of the tumours (52.94% N:9) were epithelial serous OC (Clear cells: 11.76% N:2; Endometrioid: 23.53% N:4; Mucinous: 11.76% N:4) and were diagnosed in advanced tumoural stages (III-IV: 72.72%, N:8). US study revealed a big ovarian mass with a mean largest diameter of 85.24 mm (SD: 54.17 mm, max: 17.5 cm; min:4 cm). US suspicion of malignancy was high or intermediate in 47.05% (N:8). Bilateral involvement of both ovaries was found in 6 women (54.54%). GI-RADS classified masses as grade 4 or 5 (probably/ very probably malignant) in 10 cases (58.82%). 2 cases were grade 3 (probably benign, confounded with dermoid cyst, and 4 cases were described as benign (superficial ovarian affectation and peritoneal disease without evidencing an ovarian mass). IOTA Simple Rules study were similar to GIRADS in the classification of masses as malignant (GI-RADS Grade 4 or 5), benign (GI-RADS Grade 1-2) and inconclusive (GI-RADS Grade 3). ADNEX model probability of malignancy was over 40% (Mean: 46.85% SD:34.62%). All cases, except for those with superficial and peritoneal disease, had a probability of malignancy above 30% (min: 30.2%; max: 96.6%). In this cases ADNEX model stage II-IV was more than 10% (min:12.0%; max: 78.2%) according to definitive staging. Ovarian malignant masses in premenopausal women can be found in US as big abdominal masses with suspicious characteristics of malignancy. US scores (GI-RADS, IOTA Simple Rules) can help in the differentiation between benign and malignant masses. ADNEX model can guide into the staging of dissemination of the tumours.

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