Imaging features of malignant transformation and benign malignant-mimicking lesions in the genitourinary tracts

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1 Imaging features of malignant transformation and benign malignant-mimicking lesions in the genitourinary tracts Poster No.: C-2639 Congress: ECR 2015 Type: Scientific Exhibit Authors: S. B. Park, J. B. Lee, H. J. Park; Seoul/KR Keywords: Genital / Reproductive system female, Genital / Reproductive system male, Urinary Tract / Bladder, CT, MR, PET-CT, Decision analysis, Education, Imaging sequences, Cancer, Education and training, Tissue characterisation DOI: /ecr2015/C-2639 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 47

2 Aims and objectives Common benign disease in the genitourinary tracts can undergo malignant transformation. On the other hand, some benign disease may mimic malignancy. Although the usual imaging features of common benign disease are well known to radiologists, various unusual imaging features as malignant transformation and benign malignant-mimicking lesions can be particularly misleading; therefore, both usual and unusual imaging features should always be carefully assessed. The purpose of this presentation is to describe the various clinical and imaging features of malignant transformation and benign malignant-mimicking lesions in the genitourinary tracts. Images for this section: Fig. 1 Page 2 of 47

3 Methods and materials In this presentation, we describe unusual imaging features: malignant transformation in the genitourinary tracts and benign malignant-mimicking lesions in the genitourinary tracts. We also correlate imaging features with clinical and pathologic features. Results Malignant transformation in the genitourinary tracts - malignant transformation of uterine leiomyoma - malignant transformation of adenomyosis - malignant transformation of ovarian mature cystic teratoma - malignant transformation of endometriosis Benign malignant-mimicking lesions in the genitourinary tracts - renal angiomyolipoma with minimal fat, epithelioid angiomyolipoma, aggressive renal angiomyolipoma with renal vein thrombosis - intravenous leiomyomatosis, benign metastasizing leiomyomatosis, peritoneal disseminated leiomyomatosis, retroperitoneal leiomyomatosis - high PET uptake uterine leiomyoma and adenomyosis - adenomyotic cyst - degenerated ovarian fibrothecoma - decidualized endometriosis - struma ovarii - radiation therapy change - inflammatory myoblastic tumor - solitary fibrous tumor Page 3 of 47

4 Images for this section: Fig. 2 Page 4 of 47

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44 Conclusion The major teaching points of this exhibit are: It is important to recognize both these malignant transformations and benign malignant-mimicking lesions in the genitourinary tracts. Familiarity with the clinical setting and imaging feature of both these malignant transformations and benign malignant-mimicking lesions in the genitourinary tracts will facilitate prompt and accurate diagnosis and adequate treatment. Images for this section: Fig. 42 Page 44 of 47

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46 Personal information Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, , Korea Tel) Fax) References Lee AY, Poder L, Qayyum A, Wang ZJ, Yeh BM, Coakley FV (2010) Imaging malignant and apparent malignant transformation of benign gynaecological disease. Clin Radiol 65: Namimoto T, Yamashita Y, Awai K, Nakaura T, Yanaga Y, Hirai T, Saito T, Katabuchi H (2009) Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 19: Heo SH, Lee KH, Kim JW, Jeong YY (2011) Unusual manifestation of endometrioid adenocarcinoma arising from subserosal cystic adenomyosis of the uterus: emphasis on MRI and positron emission tomography CT findings. Br J Radiol 84:e Park SB, Cho KS, Kim JK (2011) CT findings of mature cystic teratoma with malignant transformation: comparison with mature cystic teratoma. Clin Imaging 35: Yang CW, Shen SH, Chang YH, Chung HJ, Wang JH, Lin AT, Chen KK (2013) Are there useful CT features to differentiate renal cell carcinoma from lipid-poor renal angiomyolipoma? AJR Am J Roentgenol 201: Page 46 of 47

47 Chung MS, Choi HJ, Kim MH, Cho KS (2014) Comparison of T2-weighted MRI with and without fat suppression for differentiating renal angiomyolipomas without visible fat from other renal tumors. AJR Am J Roentgenol 202: Fasih N, Prasad Shanbhogue AK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, Doherty GP, Walsh C, McInnes M, Atri M (2008) Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 28: Lin CY, Ding HJ, Chen YK, Liu CS, Lin CC, Kao CH (2008) F-18 FDG PET in detecting uterine leiomyoma. Clin Imaging 32:38-41 Park SB (2014) Features of the hypointense solid lesions in the female pelvis on T2weighted MRI. J Magn Reson Imaging 39: Park SB, Cho KS, Kim JK, Lee JH, Jeong AK, Kwon WJ, Kim HH (2008) Inflammatory pseudotumor (myoblastic tumor) of the genitourinary tract. AJR Am J Roentgenol 191: Park SB, Park YS, Kim JK, Kim MH, Oh YT, Kim KA, Cho KS (2011) Solitary fibrous tumor of the genitourinary tract. AJR Am J Roentgenol 196:W Page 47 of 47