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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 16  |  Issue : 1  |  Page : 225-226

Papillary projections in ovarian tumors: Ultrasonographic evaluation


Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India

Date of Submission28-Jul-2020
Date of Decision09-Oct-2020
Date of Acceptance21-Dec-2020
Date of Web Publication29-Jul-2021

Correspondence Address:
Dr. Suresh Phatak
Professor, Department of Radiodiagnosis, JNMC, Sawangi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_285_20

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How to cite this article:
Phatak S, Lakhkar B, Varma A, Gupta R. Papillary projections in ovarian tumors: Ultrasonographic evaluation. J Datta Meghe Inst Med Sci Univ 2021;16:225-6

How to cite this URL:
Phatak S, Lakhkar B, Varma A, Gupta R. Papillary projections in ovarian tumors: Ultrasonographic evaluation. J Datta Meghe Inst Med Sci Univ [serial online] 2021 [cited 2021 Sep 23];16:225-6. Available from: http://www.journaldmims.com/text.asp?2021/16/1/225/322625



Sir,

Papillary projections as described in pathology, within an ovarian mass, are very important diagnostic clue toward epithelial stromal tumor, commonly called as epithelial tumors, which can manifest as benign, borderline, or malignant disease.[1],[2] This is applicable to pathology because, on ultrasound, a clot or any other amorphous material may look like a true papillary projection. Papillary projection can be defined at pathology consisting of folding of the growing proliferating neoplastic epithelium on a central fibrovascular stromal core.[1] Solid papillary projections on sonography are defined as any solid projections in the cyst cavity from the cyst wall with a height of ≥3 mm. Solid papillary projections are described as being smooth or irregular-like cauliflower [Figure 1], [Figure 2], [Figure 3].[3] Identification of papillary projections on an imaging study is the single best predictor of an epithelial neoplasm and may correlate with the aggressiveness of the tumor. Papillary projections are usually not seen in benign cystadenomas; if they are present, they are generally quite small. Papillary projections are identified in epithelial tumors with low malignant potential and are often present in invasive carcinoma.[2] In case of pregnant women, ovarian cysts showing ground-glass echogenicity and papillations with a smooth contour on ultrasound have high possibility of decidualized endometriomas, whereas cysts with anechoic or low-level echogenicity and papillations with an irregular contour indicate possibility of borderline malignancy.[4]
Figure 1: Gray scale ultra sonography image - Ovarian cyst adenocarcinoma showing papillary projections and measurements of base and height (5 x 3.5 mm and 9 x 14.6 mm) in size

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Figure 2: Doppler showing vascular pedicle at base of papillary projections

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Figure 3: Diagrammatic representation of measurement in solid papillary projection

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Krigman H, Bentley R, Robboy SJ. Pathology of epithelial ovarian tumors. Clin Obstet Gynecol 1994;37:475-91.  Back to cited text no. 1
    
2.
Outwater EK, Huang AB, Dunton CJ, Talerman A, Capuzzi DM. Papillary projections in ovarian neoplasms: Appearance on MRI. J Magn Reson Imaging 1997;7:689-95.  Back to cited text no. 2
    
3.
Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I, et al. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: A consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol 2000;16:500-5.  Back to cited text no. 3
    
4.
Mascilini F, Savelli L, Scifo MC, Exacoustos C, Timor-Tritsch IE, de Blasis I, et al. Ovarian masses with papillary projections diagnosed and removed during pregnancy: Ultrasound features and histological diagnosis. Ultrasound Obstet Gynecol 2017;50:116-23.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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