TITLE:
Advances in Ultrasonic Differential Diagnosis between Ovarian Clear Cell Carcinoma and Atypical Ovarian Endometrioma
AUTHORS:
Liping Liu, Jiaxin Wang
KEYWORDS:
Ovarian Clear Cell Carcinoma, Atypical Ovarian Endometrioma, Ultrasonography, Radiomics, Differential Diagnosis
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.10,
October
19,
2026
ABSTRACT: Ovarian clear cell carcinoma (OCCC) is a distinct subtype of epithelial ovarian cancer, characterized by a propensity for early metastasis, resistance to platinum-based chemotherapy, and poor prognosis. It is closely associated with endometriosis, with more than 50% of cases concurrent with endometriosis. Ovarian endometrioma (OMA) is the most common manifestation of endometriosis; among OMAs, atypical ovarian endometrioma (AE) exhibits features such as thickened cyst walls, papillary projections, and irregular septations, which overlap with the ultrasound findings of some early-stage OCCC, posing considerable challenges in preoperative differential diagnosis. Transvaginal ultrasound, as the first-line imaging modality for ovarian lesions, plays an irreplaceable role in distinguishing benign from malignant lesions. However, conventional two-dimensional and color Doppler ultrasound relies heavily on the subjective judgment of the examiner, with limited capacity to differentiate atypical lesions. In recent years, emerging technologies including contrast-enhanced ultrasound, elastography, radiomics, and artificial intelligence have developed rapidly, extracting diagnostic information from multiple dimensions—such as microcirculatory perfusion, tissue stiffness, and quantitative texture features—that are difficult to discern by the naked eye. Moreover, multimodal combined diagnostic strategies have significantly improved the differential diagnostic performance for OCCC and AE. This article systematically reviews the research progress in the ultrasound differential diagnosis of OCCC and AE from the perspectives of clinicopathological features, conventional ultrasound findings, applications of new ultrasound technologies, and multimodal combined diagnosis, and summarizes the existing problems and future perspectives, aiming to provide a reference for accurate noninvasive preoperative differentiation and individualized patient management.