What are the major imaging features that suggest presence of an ovarian cancer?
An ovarian mass that may be completely solid, partially solid, or completely cystic, with variable presence of calcification, cystic change, necrosis, hemorrhage, wall thickening, internal septations, mural nodules, or papillary projections. Larger size and documented growth over time favor malignancy. Enhancement of solid components on CT or MRI and blood flow on color and spectral Doppler US also favor malignancy. Associated findings of peritoneal spread of tumor may be seen when ovarian malignancy is present, including complex ascites; peritoneal, mesenteric, or omental masses or infiltrative soft tissue implants; and diffuse peritoneal thickening and enhancement. Lymphadenopathy and distant metastases also may be present.