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Clinical and Ultrasound Features of Type I and Type II Epithelial Ovarian Cancer

Alcázar, Juan Luis MD, PhD; Utrilla-Layna, Jesús MD; Mínguez, José Ángel MD, PhD; Jurado, Matías MD, PhD

International Journal of Gynecological Cancer: May 2013 - Volume 23 - Issue 4 - p 680–684
doi: 10.1097/IGC.0b013e31828bdbb6
Ovarian Cancer

Objective The objective of this study was to assess whether there are differences on ultrasound features between epithelial ovarian cancer (EOC) type I and type II.

Methods This was a retrospective study comprising 244 women (mean age, 55.2 years old) with histologically proven EOC treated at our institution over a 12-year period. Clinical (patient age and symptoms and tumor stage), ultrasound (tumor volume, tumor appearance on gray-scale ultrasound, and color score), and histopathologic records were reviewed. Tumors were classified as EOC type I or type II. Type I tumors comprise low-grade serous, low-grade endometrioid, clear cell, mucinous, and transitional cell carcinomas, whereas type II tumors comprise high-grade serous, high-grade endometrioid, malignant mixed mesodermal tumors, and undifferentiated carcinomas. Categorical variables were compared using χ2 test. Continuous variables were compared using 1-way analysis of variance with Bonferroni post hoc test or Mann-Whitney U or Kruskal-Wallis test, depending on data distribution.

Results Sixty-seven women (27.5%) had type I EOC, and 177 (72.3%) had type II EOC. We observed that women with type I EOC were younger, presented asymptomatic at diagnosis more frequently, and had lower CA-125 levels and lower tumor stage than women with type II EOC. Type II EOCs were more frequently identified as a solid mass and were smaller lesions than type I EOC.

Conclusions Some differences exist between type I and type II EOC in clinical and ultrasound manifestations. Although the clinical significance of these findings is still to be determined, this information could provide some clues to clinicians faced with the diagnosis of ovarian cancer.

Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.

Address correspondence and reprint requests to Juan Luis Alcázar, MD, PhD, Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Avenida Pio XII, 36 31008 Pamplona, Spain. E-mail:

The authors declare no conflicts of interest.

Received December 17, 2012

Accepted February 6, 2013

Copyright © 2013 by IGCS and ESGO