Article Text

Download PDFPDF

2022-RA-1705-ESGO How to differentiate between true positives and false positives in the diagnosis of borderline ovarian tumors
  1. Nadiezhda Rodriguez1,2,
  2. Nicolas Rodriguez1,
  3. Nathalia Ayala1,
  4. Catalina Buritica3,2,
  5. Ángela Nastar2,
  6. Camila Saravia2,
  7. Natalia Ramírez2 and
  8. Alba Esquivel1
  1. 1Gynaecology, Fundacion Santa Fe de Bogota, Bogota, Colombia
  2. 2School of medicine, Universidad de los Andes, Bogota, Colombia
  3. 3Pathology, Fundacion Santa Fe de Bogota, Bogota, Colombia


Introduction/Background Currently, the diagnosis of borderline ovarian tumors (BOT) by ultrasound is a challenge. Our study proposes how to differentiate between true positives (TP) and false positives (FP) in the diagnosis of BOT

Methodology A retrospective study of patients who underwent transvaginal ultrasound with a diagnosis of adnexal mass and a subsequent surgery between 2012 and 2022 at a tertiary referral university hospital with a gynaecological oncology unit. The IOTA ADNEX model was used to estimate the probability of benignancy or malignancy, with a cut-off of 10% for malignancy. Pathology was the reference standard used. Descriptive statistics and bivariate analysis were performed.

Results For a total of 757 patients, the IOTA ADNEX model identified 171 (22.4%) masses as malignant, of which 64 (37.4%) were classified as BOT. 18 (28%) masses were confirmed as TP by histopathology and 46 (72%) as FP. Its usual ultrasound characteristics were similar with the particularity of having a greater number of papillae and blood vessels in papillary projections in the TP. Therefore, additional sonographic features, such as the presence of a low level of echogenicity content and a pattern of microcystic tissue resembling a cluster of tiny bubbles, were evaluated. These characteristics were relevant in most of the TP. Regarding the FP, histopathology showed that 40% were serous cystadenofibrome, 20% ovarian tube abscess, 10% Low-grade serous carcinomas, among others.

Conclusion Our findings show how some usual and novel features in ultrasound are necessary for an adequate differentiation of BOT.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.