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Mittermair C, Cunha TM, Urbas R, Koch H, Forstner R. Sclerosing stromal tumor of the ovary: a case series and review of literature. BJR Case Rep 2022; 8:20210155. [PMID: 36177258 PMCID: PMC9499441 DOI: 10.1259/bjrcr.20210155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/11/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022] Open
Abstract
Sclerosing stromal tumor of the ovary is a rare benign sex-cord stromal tumor that affects primarily young females. In a series of six patients (mean 24,6, median 19 years) findings of six MRIs and one CT were analyzed. Unilateral tumors ranging from 6 to 8 cm were found in all patients. The tumors were well encapsulated and polylobulated. The morphology was mixed solid and cystic in three and solid in three patients. In CT, a hypervascular tumor with centripetal enhancement was seen. In MRI T2 weighted imaging showed low signal intensity of the solid tissue in all cases and low diffusion-weighted imaging signal of the solid tissue in high b-value diffusion-weighted imaging in three patients. Contrast enhancement was avid with extension from the periphery in all patients. Knowledge of these distinct radiological features of sclerosing stromal tumor is important, as in the Ovarian-Adnexal Reporting and Data System risk classification system this may be scored as Ovarian-Adnexal Reporting and Data System 5. Because of its non-aggressive clinical course, pre-operative imaging assists to avoid unnecessary extensive surgery and to preserve the patient’s fertility by only resecting the tumor and preserving the ovary. Sclerosing stromal tumor of the ovary presents pathognomonic features in MRI that allow a specific pre-operative diagnosis and selecting candidates for fertility-sparing surgery.
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Affiliation(s)
| | - Teresa Margarida Cunha
- Department of Radiology, Instituto Portugues de Oncologia de Lisboa – IPOLFG, Lisbon, Portugal
| | - Romana Urbas
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - Horst Koch
- Department of Gynecology, Paracelsus Medical University, Salzburg, Austria
| | - Rosemarie Forstner
- Department of Radiology, Paracelsus Medical University, Salzburg, Austria
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2
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Comprehensive review of imaging features of sex cord-stromal tumors of the ovary. Abdom Radiol (NY) 2021; 46:1519-1529. [PMID: 33725145 DOI: 10.1007/s00261-021-02998-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/03/2021] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
Sex cord-stromal tumors of the ovary (SCST) are uncommon ovarian tumors arising from sex cord and/or stromal cells of the ovaries. They may be nonfunctional and asymptomatic or functional presenting with hyperestrogenic, hyperandrogenic or cushingoid symptoms. They present in a wide age group of women, mostly in early stages and follow a nonaggressive clinical course after surgical resection. They differ from more prevalent epithelial ovarian tumors which tend to present in older women in advanced stages with poor prognosis. Some of SCSTs are associated with clinical syndromes. We will review imaging features on ultrasound, computed tomography and magnetic resonance imaging, epidemiology and clinical presentations of these tumors.
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3
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Ovarian Sclerosing Stromal Tumor and Müllerian Cyst in an 11-yr-old Girl: A Case Report and Review of the Literature. Int J Gynecol Pathol 2019; 39:e5-e10. [PMID: 31433378 DOI: 10.1097/pgp.0000000000000629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sclerosing stromal tumor (SST) is an extremely rare ovarian neoplasm that primarily affects young female individuals. Patients with SST often present with pelvic pain and menstrual irregularities. Herein, we report a case of SST of the ovary in an 11-yr-old girl with symptoms of abdominal pain and menstrual irregularities. A preoperative diagnosis of tumors in the left adnexa and right ovary was made by pelvic ultrasonography and magnetic resonance imaging, and the patient underwent exploratory laparotomy and laparoscopic cystectomy. The ovarian masses were removed and proven to be SST in the left ovary and Müllerian cyst in the right fallopian tube on histopathologic examination and immunochemistry. To our knowledge, the 11-yr-old patient presented here was the only case with SST and Müllerian cyst simultaneously.
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4
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Tian T, Zhu Q, Chen W, Wang S, Sui W, Wu J. CT findings of sclerosing stromal tumor of the ovary: A report of two cases and review of the literature. Oncol Lett 2016; 11:3817-3820. [PMID: 27313700 DOI: 10.3892/ol.2016.4441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/16/2016] [Indexed: 12/16/2022] Open
Abstract
Sclerosing stromal tumor (SST) of the ovary, which was first described by Chalvardjian and Scully in 1973, is a rare ovarian neoplasm, occurring predominantly in young women. The most common clinical symptom in patients with SST is menstrual irregularities. Microscopically, the tumor is characterized by the presence of pseudo-lobulated cellular areas, with a prominent tendency to sclerosis, marked vascularity and pronounced variation in cellular size and shape. In the current study, 2 cases of SST of the ovary are presented. These cases were confirmed by imaging, surgical and histological examination. No adjuvant therapy was administered to the patients and the two patients were disease-free with no imaging findings of recurrence or metastasis 24 months following surgery.
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Affiliation(s)
- Tongtong Tian
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Medical School of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - Qingqiang Zhu
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Medical School of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - Wenxin Chen
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Medical School of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - Shouan Wang
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Medical School of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - Weifan Sui
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Medical School of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
| | - Jingtao Wu
- Department of Radiology, Subei People's Hospital of Jiangsu Province, Medical School of Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China
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5
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Choi JI, Park SB, Han BH, Kim YH, Lee YH, Park HJ, Lee ES. Imaging features of complex solid and multicystic ovarian lesions: proposed algorithm for differential diagnosis. Clin Imaging 2015; 40:46-56. [PMID: 26277385 DOI: 10.1016/j.clinimag.2015.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/26/2015] [Accepted: 06/15/2015] [Indexed: 12/12/2022]
Abstract
Complex solid and multicystic ovarian lesions are broad-spectrum diseases, ranging from benign to malignant. This article describes the broad-spectrum and imaging features of complex solid and multicystic ovarian lesions and illustrates an algorithmic approach to such lesions, focusing on the ultrasonography and magnetic resonance imaging features that allow one to hone the differential diagnosis. Multimodality imaging workup plays an important role in the characterization and differential diagnosis of these diseases. Also, knowledge of the clinical setting and imaging features for the spectrum of complex solid and multicystic ovarian lesions can lead to appropriate management.
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Affiliation(s)
- Ji In Choi
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea.
| | - Byoung Hee Han
- Department of Radiology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, 17, Seoae-ro 1-gil, Jung-gu, Seoul, 100-380, Korea
| | - Young Hwa Kim
- Department of Radiology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, 17, Seoae-ro 1-gil, Jung-gu, Seoul, 100-380, Korea
| | - Young Ho Lee
- Department of Radiology, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, 17, Seoae-ro 1-gil, Jung-gu, Seoul, 100-380, Korea
| | - Hyun Jeong Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
| | - Eun Sun Lee
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 156-755, Korea
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6
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Furukawa S, Kanno K, Kojima M, Ohara M, Soeda S, Suzuki S, Watanabe T, Nishiyama H, Honda T, Fujimori K. Sclerosing stromal tumor of the ovary treated with 2-incision total laparoscopic cystectomy. Int J Surg Case Rep 2015; 9:72-4. [PMID: 25732615 PMCID: PMC4392182 DOI: 10.1016/j.ijscr.2015.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 01/30/2015] [Accepted: 02/02/2015] [Indexed: 11/23/2022] Open
Abstract
Sclerosing stromal tumor (SST) is an extremely rare benign tumor of the ovary and preoperative diagnosis of SST is difficult as it often mimics a malignant tumor. SST occurs in young women. Many cases of SST were treated by abdominal oophorectomy and laparoscopic surgery is seldom performed in SST cases. We report a case of SST of the ovary in an 18-year-old girl who was diagnosed by preoperative imaging and underwent laparoscopic cystectomy.
Sclerosing stromal tumor (SST) is an extremely rare benign tumor of the ovary that is derived from the sex cord stroma [1,2] and occurs in young women [3–11]. Preoperative diagnosis of the tumor is difficult as it often mimics a malignant tumor. Oophorectomy is usually performed in many cases of young women [3], and diagnosis of SST is made based on post-operative pathological examination. Laparoscopic surgery is seldom performed in SST cases. Here, we report a case of SST of the ovary in an 18-year-old girl who was diagnosed by preoperative imaging and underwent laparoscopic cystectomy. Accurate preoperative imaging helped to perform minimally invasive surgery for SST.
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Affiliation(s)
- Shigenori Furukawa
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.
| | - Kiyoshi Kanno
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Manabu Kojima
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Miki Ohara
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Shu Soeda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Satoshi Suzuki
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Takafumi Watanabe
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hiroshi Nishiyama
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Tsuyoshi Honda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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7
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Heo SH, Kim JW, Shin SS, Jeong SI, Lim HS, Choi YD, Lee KH, Kang WD, Jeong YY, Kang HK. Review of Ovarian Tumors in Children and Adolescents: Radiologic-Pathologic Correlation. Radiographics 2014; 34:2039-55. [DOI: 10.1148/rg.347130144] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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8
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Onur MR, Simsek BC, Kazez A. Sclerosing stromal tumor of the ovary: ultrasound elastography and MRI findings on preoperative diagnosis. J Med Ultrason (2001) 2011; 38:217-20. [PMID: 27278587 DOI: 10.1007/s10396-011-0311-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 05/04/2011] [Indexed: 11/27/2022]
Abstract
Sclerosing stromal tumor (SST) is a benign stromal tumor of the ovary. Preoperative diagnosis of this benign tumor mainly depends on imaging findings. Dynamic computed tomography (CT) and magnetic resonance imaging (MRI) show typical contrast enhancement of SST with peripheral enhancement in the early phase and centripetal progression in the delayed phases. We present the imaging findings of ultrasonography, ultrasound elastography, and dynamic MRI in the diagnosis of SST. Abdominal ultrasound elastography is a novel technique that depicts the stromal structure of SSTs by comparing the elasticity of the tumor and the myometrium using quantitative strain values.
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Affiliation(s)
- Mehmet Ruhi Onur
- Department of Radiology, University of Firat Faculty of Medicine, Firat Universitesi Hastanesi Rektorluk Kampusu, 23119, Elazig, Turkey.
| | | | - Ahmet Kazez
- Department of Pediatric Surgery, University of Firat Faculty of Medicine, Elazig, Turkey
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9
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Park SM, Kim YN, Woo YJ, Choi HS, Lee JS, Heo SH, Kim CJ. A sclerosing stromal tumor of the ovary with masculinization in a premenarchal girl. KOREAN JOURNAL OF PEDIATRICS 2011; 54:224-7. [PMID: 21829415 PMCID: PMC3145908 DOI: 10.3345/kjp.2011.54.5.224] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 11/12/2010] [Accepted: 12/17/2010] [Indexed: 01/05/2023]
Abstract
A sclerosing stromal tumor of the ovary is an extremely rare benign tumor; it usually is found during the second and third decades of life. Patients present with pelvic pain or a palpable abdominal mass. Hormonal effects such as masculinization are uncommon. Here, an 11-year old premenarchal girl presented with deepening of the voice. In addition, clitoromegaly and hirsutism with a male suprapubic hair pattern were observed. The laboratory findings showed that the testosterone level was elevated to 3.67 ng/mL, andostenedione to above 10 ng/mL, dehydroepiandrosterone-sulfate to 346 µg/dL and 17-hydroxy progesterone (17-OHP) to 11.28 ng/mL. The chromosome evaluation revealed a 46,XX female karyotype. An adrenocorticotropic hormone stimulation test was performed. The 17-OHP to cortisol ratio in 30 minutes was 0.045, which suggested a heterozygote for the 21-hydroxylase deficiency. However, the CYP21A2 gene encoding steroid 21-hydroxylase showed normal. The pelvic ultrasound showed a heterogeneous mass consisting of predominantly solid tissue in the pelvic cavity. The pelvic magnetic resonance imaging revealed an 8.9×6.2×6.6 cm mass of the left ovary. A left oophrectomy was performed and microscopic examination confirmed a sclerosing stromal tumor. Immunohistochemical studies showed that the tumor was positive for smooth muscle actin and vimentin, but negative for S-100 protein and cytokeratin. Following surgery, the hormone levels returned to the normal range and the hirsutism resolved.
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Affiliation(s)
- Soo Min Park
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
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10
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Bouic-Pagès E, Perrochia H, Mérigeaud S, Giacalone PY, Taourel P. [MR Imaging of primary ovarian tumors with pathologic correlation]. ACTA ACUST UNITED AC 2009; 90:787-802. [PMID: 19752784 DOI: 10.1016/s0221-0363(09)73210-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Ovarian tumors are classified based on the cell of origin into epithelial tumors, germ cell tumors and sex cord-stromal tumors. This pictorial essay illustrates the MR imaging features of the main ovarian tumors with pathologic correlation. These key features are helpful to suggest a specific diagnosis or narrow the differential diagnosis, in order to optimize the surgical approach.
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Affiliation(s)
- E Bouic-Pagès
- Service d'Imagerie médicale, Hôpital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5
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11
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Wada H, Mitsumori A, Hyoudou T, Matsubara S, Yamamoto M, Fujisawa M, Akamatsu N, Kanazawa S. Sclerosing stromal tumor of the ovary with atypical magnetic resonance imaging findings in a middle-aged woman. Jpn J Radiol 2009; 27:247-51. [PMID: 19626411 DOI: 10.1007/s11604-009-0331-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 05/07/2009] [Indexed: 10/20/2022]
Abstract
We encountered a case of atypical sclerosing stromal tumor of the ovary (SST) in a middle-aged woman. This 52-year-old woman presented with a 2-year history of abdominal distention. Magnetic resonance imaging (MRI) showed a large mass extending from the pelvis to the epigastrium. T2-weighted MRI showed an island-shaped area of slight hyperintensity. Dynamic MRI demonstrated gradual light enhancement of the area in which T2-weighted imaging showed low intensity. The diagnosis of the tumor proved difficult because neither MRI findings nor the age of getting sick were atypical. We report this case with MRI findings and correlated pathology.
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Affiliation(s)
- Hiroko Wada
- Department of Radiology, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji 670-8540, Japan.
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12
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Chang YW, Hong SS, Jeen YM, Kim MK, Suh ES. Bilateral sclerosing stromal tumor of the ovary in a premenarchal girl. Pediatr Radiol 2009; 39:731-4. [PMID: 19283376 DOI: 10.1007/s00247-009-1190-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 12/26/2008] [Accepted: 01/29/2009] [Indexed: 10/21/2022]
Abstract
Sclerosing stromal tumor (SST) is a rare benign ovarian neoplasm classified as a type of sex cord stromal tumor that occurs predominantly in young patients. Several reports have described the US, CT and MR features of SST, but there have been no reports of a bilateral calcified SST in a child. We present a case of a bilateral SST of the ovary with calcification in a 12-year-old premenarchal girl and describe the US, CT, MR and pathological findings.
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Affiliation(s)
- Yun-Woo Chang
- Department of Radiology, Soonchunhyang University Hospital, 22 Daesakwan-gil, Yongsan-ku, Seoul, 140-743, Korea.
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13
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Abstract
Adnexal masses are common in women of all ages. A range of physiological and benign ovarian conditions that develop in women, especially in the reproductive age, and adnexal malignancies can be evaluated with magnetic resonance imaging (MRI). Management of women with adnexal masses is frequently guided by imaging findings; therefore, precise characterization of adnexal pathology should be performed whenever possible. Magnetic resonance imaging is useful in characterization of adnexal masses that are not completely evaluated by ultrasound because it can provide additional information on soft tissue composition of adnexal masses based on specific tissue relaxation times and allows multiplanar imaging at large field of view to define the origin and extent of pelvic pathology. The patients most likely to benefit from MRI are pregnant women and those who are premenopausal and have masses that have complex features on ultrasound but do not have raised cancer antigen 125 tumor marker levels. The overlap in imaging appearance among different cell type malignancies makes it difficult to predict exact histology based on MRI appearance; however, MRI has a high accuracy in differentiating benign from malignant masses. Teratomas, endometriomas, simple and hemorrhagic cysts, fibromas, exophytic or extrauterine fibroids, and hydrosalpinges can be diagnosed with high confidence. In this article, the authors review the histopathologic background and MRI features of adnexal masses and discuss the role of MRI in the differentiation of benign from malignant adnexal pathologies.
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Affiliation(s)
- Kavita Rajkotia
- The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD 21287, USA
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14
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Abstract
MR imaging has become an important tool in the evaluation of patients with adnexal disease, and its role continues to evolve. Some benign entities can be diagnosed by MR imaging with a high grade of confidence, such as teratomas, endometriomas, simple and hemorrhagic cysts, fibromas, and hydrosalpinx. In cases of malignant lesions, MR imaging may be more accurate than other modalities for lesion characterization, staging, and follow-up.
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Affiliation(s)
- Claudia P Huertas
- Department of Radiology, University of North Carolina, 101 Manning Drive, CB7510, Chapel Hill, NC 27599-7510, USA
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15
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Chang W, Oiseth SJ, Orentlicher R, Agarwal G, Yahr LJ, Cayten CG. Bilateral sclerosing stromal tumor of the ovaries in a premenarchal girl. Gynecol Oncol 2006; 101:342-5. [PMID: 16403568 DOI: 10.1016/j.ygyno.2005.10.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Revised: 10/14/2005] [Accepted: 10/15/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Sclerosing stromal tumor of the ovary is a rare benign neoplasm that is usually unilateral in menstruating women with a mean age of 27. CASE An 11-year-old girl presented with asymptomatic bilateral sclerosing stromal tumor of the ovaries prior to menarche. We describe the clinical, radiologic and histologic findings with reference to other reported cases. CONCLUSION We herein report a unique case of bilateral sclerosing stromal tumor of the ovaries arising in a premenarchal girl.
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Affiliation(s)
- Winston Chang
- Department of Surgery, Our Lady of Mercy Medical Center, New York Medical College, 600 East 233rd Street, Bronx, NY 10466, USA
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16
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Tanaka YO, Tsunoda H, Kitagawa Y, Ueno T, Yoshikawa H, Saida Y. Functioning ovarian tumors: direct and indirect findings at MR imaging. Radiographics 2005; 24 Suppl 1:S147-66. [PMID: 15486238 DOI: 10.1148/rg.24si045501] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There are many kinds of ovarian tumors and tumorlike conditions that produce estrogen or androgen. Magnetic resonance imaging can demonstrate not only ovarian tumors but also an enlarged uterus with a thick endometrium, even in cases of a clinically latent excess of estrogen. These clinical and indirect imaging findings can aid in the differential diagnosis of ovarian tumors. Granulosa cell tumor and thecoma are well-known estrogen-producing tumors. In pediatric or postmenopausal patients, they manifest as precocious pseudopuberty or postmenopausal bleeding, respectively. Conversely, Sertoli-Leydig cell tumor is representative of hormone-producing tumors that cause virilization. However, there are other functioning ovarian tumors besides the sex cord-stromal tumors. It is well known that metastatic ovarian tumors often have androgen-producing stroma and that mucinous cystadenoma sometimes produces estrogens. Most other ovarian tumors can produce sexual hormones in their stroma. In addition, some endocrinologic abnormalities (eg, polycystic ovary syndrome) also cause virilization.
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Affiliation(s)
- Yumiko O Tanaka
- Department of Radiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
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17
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Jung SE, Rha SE, Lee JM, Park SY, Oh SN, Cho KS, Lee EJ, Byun JY, Hahn ST. CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary. AJR Am J Roentgenol 2005; 185:207-15. [PMID: 15972425 DOI: 10.2214/ajr.185.1.01850207] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this article was to research the clinical and imaging features of sex cord-stromal tumors of the ovary to help in specific diagnosis of ovarian tumors. Sex cord-stromal tumors of the ovary are rare ovarian neoplasms, which arise from stromal cells and primitive sex cords in the ovary. The common types are granulosa cell tumors, fibrothecomas, sclerosing stromal tumors, and Sertoli-Leydig cell tumors. They account for most of the hormonally active ovarian tumors. They have characteristic imaging features in each type of the tumor. CONCLUSION Clinical and radiologic clues are helpful in differential diagnosis from the more common epithelial tumors; sex cord-stromal tumors primarily are treated surgically and have generally good prognosis.
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Affiliation(s)
- Seung Eun Jung
- Department of Radiology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #62, Youidodong, Youngdeungpo-gu, Seoul 150-713, South Korea.
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18
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Abstract
Sclerosing stromal tumors are rare benign ovarian neoplasms that are usually diagnosed in the second or third decade of life. Most patients with these tumors present with menstrual irregularities and pelvic pain. We present the magnetic resonance imaging (MRI) findings of a left ovarian sclerosing stromal tumor with torsion that was located in the right parauterine area, and discuss the differential diagnosis for this entity based on MRI findings. In this case, MRI demonstrated a well-defined, predominantly solid mass with a pseudolobular pattern, and showed a shift of the uterus to the left. The surgical and histopathologic aspects of the case are also described.
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Affiliation(s)
- H Yerli
- Department of Radiology, Baskent University School of Medicine, Ankara, Turkey.
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