Could you recognize an ovarian tumor on CT?

Computed tomographic findings in dogs with ovarian tumors: A tortuous ovarian artery consistently identifies ovarian origin in complex abdominal masses

Martina Manfredi, Simona Morabito, Quentin Fournier, Ioannis Panopoulos, Florence Thierry, Tobias Schwarz, Cristobal Lopez, Manuela Baldinetti, Chiara Massarenti, Davide Danilo Zani, Maurizio Longo

Background
Ovarian tumors in dogs, while uncommon, require precise diagnostic imaging to determine their origin and characteristics. This study investigates the computed tomography (CT) features of ovarian tumors in dogs, focusing on the tortuous ovarian artery as a potential diagnostic marker for identifying ovarian origin in complex abdominal masses.

Methods
A retrospective, multicentric study was conducted, including 20 dogs diagnosed with ovarian tumors through cytology or histology. Pre- and post-contrast CT scans were analyzed to assess tumor features, associated thoracoabdominal changes, and potential metastases. Statistical analysis explored associations between tumor types, dimensions, and CT characteristics.

Results
Subjects and Tumors: Among 25 tumors (15 carcinomas, 4 granulosa cell tumors, 2 luteomas, 1 teratoma, 1 dysgerminoma, and 2 poorly differentiated malignant neoplasms), most were large, heterogeneous, lobulated masses located near the ipsilateral kidney.

Key CT Features:
-A tortuous ovarian artery was observed in all cases and associated with an enlarged gonadal vein in 12 cases.
-Larger tumors were more likely to exhibit rupture, peritoneal effusion, and lymphadenopathy.
 
Metastasis: 45% of cases showed presumed or confirmed metastases, primarily via peritoneal carcinomatosis, hematogenous, and lymphatic routes.

Common metastatic sites included the lungs, liver, and spleen.

No Tumor-Specific CT Associations: Tumor type was not correlated with specific CT features. However, tumor size was linked to location and associated thoracoabdominal changes.

Peritoneal Effusion: Frequently observed, potentially due to tumor rupture or mechanical/lymphatic obstruction.

Limitations
The study’s small sample size and lack of standardized CT protocols limited its ability to generalize findings. Some presumed metastases were not histologically confirmed.

Conclusions
A tortuous ovarian artery is a consistent CT marker for ovarian origin in complex abdominal masses in dogs. Larger tumors are associated with specific CT features like rupture and effusion, aiding diagnosis and surgical planning. However, tumor type could not be differentiated based on CT findings alone.

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