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Abstract：
BACKGROUND: Collision tumor are neoplasms, including two histologically distinct tumors that coexist in the same mass without histological admixture. The incidence of collision tumor is low and is rare clinically.
OBJECTIVE: To investigate ultrasound images and application of ovarian-adnexal reporting and data system (O-RADS) to evaluate the risk and pathological characteristics of ovarian collision tumor.
METHODS: This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023. All clinical features, ultrasound images and histopathological features were collected and analyzed. The O-RADS score was used for classification. The O-RADS score was determined by two senior doctors in the gynecological ultrasound group. Lesions with O-RADS score of 1-3 were classified as benign tumors, and lesions with O-RADS score of 4 or 5 were classified as malignant tumors.
RESULTS: There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery. The average age of 17 women with ovarian collision tumor was 36.7 years (range 20-68 years), in whom, one occurred bilaterally and the rest occurred unilaterally. The average tumor diameter was 10 cm, of which three were 2-5 cm, 11 were 5-10 cm, and three were > 10 cm. Five (29.4%) tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma, and unilocular or multilocular cysts contained a small number of parenchymal components. Eleven (64.7%) tumors had an O-RADS score of 4, including two in category 4A, six in category 4B, and three in category 4C; all of which were multilocular cystic tumors with solid components or multiple papillary components. One (5.9%) tumor had an O-RADS score of 5. This case was a solid mass, and a small amount of pelvic effusion was detected under ultrasound. The pathology was high-grade serous cystic cancer combined with cystic mature teratoma. There were nine (52.9%) tumors with elevated serum carbohydrate antigen (CA)125 and two (11.8%) with elevated serum CA19-9. Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common, which was different from previous results.
CONCLUSIONS: The ultrasound images of ovarian collision tumor have certain specificity, but diagnosis by preoperative ultrasound is difficult. The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor. The O-RADS score of ovarian collision tumor is mostly ≥ 4, which can sensitively detect malignant tumors.
OBJECTIVE: To investigate ultrasound images and application of ovarian-adnexal reporting and data system (O-RADS) to evaluate the risk and pathological characteristics of ovarian collision tumor.
METHODS: This study retrospectively analyzed 17 cases of ovarian collision tumor diagnosed pathologically from January 2020 to December 2023. All clinical features, ultrasound images and histopathological features were collected and analyzed. The O-RADS score was used for classification. The O-RADS score was determined by two senior doctors in the gynecological ultrasound group. Lesions with O-RADS score of 1-3 were classified as benign tumors, and lesions with O-RADS score of 4 or 5 were classified as malignant tumors.
RESULTS: There were 17 collision tumors detected in 16 of 6274 patients who underwent gynecological surgery. The average age of 17 women with ovarian collision tumor was 36.7 years (range 20-68 years), in whom, one occurred bilaterally and the rest occurred unilaterally. The average tumor diameter was 10 cm, of which three were 2-5 cm, 11 were 5-10 cm, and three were > 10 cm. Five (29.4%) tumors with O-RADS score 3 were endometriotic cysts with fibroma/serous cystadenoma, and unilocular or multilocular cysts contained a small number of parenchymal components. Eleven (64.7%) tumors had an O-RADS score of 4, including two in category 4A, six in category 4B, and three in category 4C; all of which were multilocular cystic tumors with solid components or multiple papillary components. One (5.9%) tumor had an O-RADS score of 5. This case was a solid mass, and a small amount of pelvic effusion was detected under ultrasound. The pathology was high-grade serous cystic cancer combined with cystic mature teratoma. There were nine (52.9%) tumors with elevated serum carbohydrate antigen (CA)125 and two (11.8%) with elevated serum CA19-9. Histological and pathological results showed that epithelial-cell-derived tumors combined with other tumors were the most common, which was different from previous results.
CONCLUSIONS: The ultrasound images of ovarian collision tumor have certain specificity, but diagnosis by preoperative ultrasound is difficult. The combination of epithelial and mesenchymal cell tumors is one of the most common types of ovarian collision tumor. The O-RADS score of ovarian collision tumor is mostly ≥ 4, which can sensitively detect malignant tumors.
摘要：
背景：碰撞肿瘤是肿瘤，包括两个组织学上不同的肿瘤，它们共存于同一肿块中，没有组织学混合。碰撞肿瘤的发生率低，临床上很少见。
目的：探讨超声图像和卵巢附件报告和数据系统（O-RADS）在评估卵巢碰撞肿瘤的风险和病理特征中的应用。
方法：本研究回顾性分析2020年1月至2023年12月经病理诊断为卵巢碰撞瘤的17例。所有临床特征,收集并分析超声图像和组织病理学特征。O-RADS评分用于分类。由妇科超声组的两名高级医生确定O-RADS评分。O-RADS评分为1-3分的病变被分类为良性肿瘤，并且O-RADS评分为4或5分的病变被分类为恶性肿瘤。
结果：在接受妇科手术的6274例患者中，有16例发现了17个碰撞肿瘤。17例卵巢碰撞肿瘤患者的平均年龄为36.7岁（范围20-68岁），在谁,一个是双边发生的，其余的是单边发生的。肿瘤平均直径10cm,其中三个是2-5厘米，11是5-10厘米，和三个是>10厘米。5例(29.4%)O-RADS评分为3分的子宫内膜异位囊肿伴纤维瘤/浆液性囊腺瘤,单眼或多房性囊肿含有少量实质成分。11个（64.7%）肿瘤的O-RADS评分为4分，其中2个为4A类，4B类中有6个，在4C类中有3个；所有这些都是多房性囊性肿瘤，具有实体成分或多个乳头状成分。一个（5.9％）肿瘤的O-RADS评分为5。这个案子是一个坚实的质量，超声检查发现少量盆腔积液。病理为高级别浆液性囊性癌合并囊性成熟畸胎瘤。有9例（52.9％）血清碳水化合物抗原（CA）125升高的肿瘤和2例（11.8％）血清CA19-9升高的肿瘤。组织学和病理结果显示以上皮细胞源性肿瘤合并其他肿瘤最为常见,这与以前的结果不同。
结论：卵巢碰撞瘤的超声图像具有一定的特异性,但术前超声诊断困难。上皮间质细胞联合瘤是卵巢碰撞瘤中最多见的类型之一。卵巢碰撞肿瘤的O-RADS评分多≥4分,可敏感检测恶性肿瘤。
目的：探讨超声图像和卵巢附件报告和数据系统（O-RADS）在评估卵巢碰撞肿瘤的风险和病理特征中的应用。
方法：本研究回顾性分析2020年1月至2023年12月经病理诊断为卵巢碰撞瘤的17例。所有临床特征,收集并分析超声图像和组织病理学特征。O-RADS评分用于分类。由妇科超声组的两名高级医生确定O-RADS评分。O-RADS评分为1-3分的病变被分类为良性肿瘤，并且O-RADS评分为4或5分的病变被分类为恶性肿瘤。
结果：在接受妇科手术的6274例患者中，有16例发现了17个碰撞肿瘤。17例卵巢碰撞肿瘤患者的平均年龄为36.7岁（范围20-68岁），在谁,一个是双边发生的，其余的是单边发生的。肿瘤平均直径10cm,其中三个是2-5厘米，11是5-10厘米，和三个是>10厘米。5例(29.4%)O-RADS评分为3分的子宫内膜异位囊肿伴纤维瘤/浆液性囊腺瘤,单眼或多房性囊肿含有少量实质成分。11个（64.7%）肿瘤的O-RADS评分为4分，其中2个为4A类，4B类中有6个，在4C类中有3个；所有这些都是多房性囊性肿瘤，具有实体成分或多个乳头状成分。一个（5.9％）肿瘤的O-RADS评分为5。这个案子是一个坚实的质量，超声检查发现少量盆腔积液。病理为高级别浆液性囊性癌合并囊性成熟畸胎瘤。有9例（52.9％）血清碳水化合物抗原（CA）125升高的肿瘤和2例（11.8％）血清CA19-9升高的肿瘤。组织学和病理结果显示以上皮细胞源性肿瘤合并其他肿瘤最为常见,这与以前的结果不同。
结论：卵巢碰撞瘤的超声图像具有一定的特异性,但术前超声诊断困难。上皮间质细胞联合瘤是卵巢碰撞瘤中最多见的类型之一。卵巢碰撞肿瘤的O-RADS评分多≥4分,可敏感检测恶性肿瘤。
