16/04/2025
🩺 Case of the Week | PurDes Radiology
Ovarian Mass Mimicking Pregnancy – A Rare Diagnostic Twist
Ovarian mass presenting as False pregnancy.
CECT Abdomen-Pelvis for reporting. Patient presenting with pelvic lump, pain in abdomen, Positive Urine pregnancy test & a Pelvic mass on USG.
Imaging findings :
• A large, 15x15 cm sized heterogeneously enhancing, solid-cystic pelvic mass lesion.
• Mild ascites & mild omental thickening. Neither o***y was seen separately.
• Fat planes between the lesion & adjacent Pelvic structures maintained.
• No significant abdominal-pelvic lymphadenopathy.
Radiological Diagnosis : Ovarian Neoplasm (most likely Germ cell tumor- considering patient’s age) with peritoneal spread.
Discussion :
Germ cell tumors are the most common ovarian masses in children & adolescents.
Ovarian malignant germ cell tumors (OMGCTs) tend to be large at the time of diagnosis and progress rapidly. They typically manifest in adolescence with abdominal pain and an abdominal mass. About 10% of patients present with an acute abdomen resulting from torsion, hemorrhage, or tumor rupture (which is more common with yolk sac tumors or mixed germ cell tumors). Less common symptoms include abdominal distention, fever, and vaginal bleeding. Duration of symptoms is usually short, with a median of 2–4 weeks.
Endocrinal manifestations resulting from hormone production by tumor cells are relatively uncommon & include menstrual irregularities, isosexual precocity, carcinoid syndrome & false positive Urine pregnancy test.
Atypical findings in this case :
• Positive urine pregnancy test.
• Peritoneal spread without evidence of lymphatic dissemination- unusual for Germ cell tumors.
Radiological Diagnosis: Ovarian Neoplasm (most likely Germ cell tumor- considering patient’s age) with peritoneal spread.
