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CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary

¹ Department of Radiology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #62, Youidodong, Youngdeungpo-gu, Seoul 150-713, South Korea.
² Department of Radiology, Asan Medical Center, University of Ulsan, Seoul 138-736, South Korea.
³ Department of Radiology, Ajou University, College of Medicine, Paldal-gu, Suwon, Kyunggi-do, South Korea.

View larger version (121K): [in a new window]   Fig. 1A —42-year-old woman with granulosa cell tumor. Unenhanced CT scan shows solid soft-tissue mass (arrows) in right adnexal area.

View larger version (133K): [in a new window]   Fig. 1B —42-year-old woman with granulosa cell tumor. After contrast administration, CT scan shows mass (arrows) as mildly and homogeneously enhanced.

View larger version (140K): [in a new window]   Fig. 2A —45-year-old woman with granulosa cell tumor. Axial T2-weighted image shows well-defined cystic tumor (arrows) with multiple small chambers.

View larger version (156K): [in a new window]   Fig. 2B —45-year-old woman with granulosa cell tumor. Axial T1-weighted image obtained after gadolinium administration shows marked enhancement of septa and solid portions with multiple small cystic areas within tumor, resulting in spongy appearance.

View larger version (114K): [in a new window]   Fig. 3A —55-year-old woman with granulosa cell tumor. Axial T1-weighted image shows large well-defined mass with multiple cystic areas of extremely low signal intensity and tiny spots (arrows) with high signal intensity that represent intratumoral hemorrhage.

View larger version (135K): [in a new window]   Fig. 3B —55-year-old woman with granulosa cell tumor. Axial T2-weighted image shows large multicystic mass with some solid portion. This is called bunch-of-grapes appearance of cystic tumor with multiple chambers.

View larger version (125K): [in a new window]   Fig. 3C —55-year-old woman with granulosa cell tumor. Axial T1-weighted image obtained after gadolinium administration shows marked enhancement of solid components in tumor.

View larger version (134K): [in a new window]   Fig. 4A —34-year-old woman with exophytic fibroma. Unenhanced CT scan shows dumbbell-shaped mass in right adnexal area.

View larger version (141K): [in a new window]   Fig. 4B —34-year-old woman with exophytic fibroma. After contrast administration, CT scan shows homogeneously enhanced anterior mass (arrows) as pedunculated fibroma and posterior heterogeneous structure as right ovary.

View larger version (158K): [in a new window]   Fig. 5A —28-year-old woman with bilateral fibromas. Upper pelvic level (A) and lower pelvic level (B) multilobulated low-signal-intensity masses are noted in both adnexal regions on T2-weighted images. Masses have typical dark signal intensity. Ovarian follicles (arrows) are noted in left adnexal area.

View larger version (163K): [in a new window]   Fig. 5B —28-year-old woman with bilateral fibromas. Upper pelvic level (A) and lower pelvic level (B) multilobulated low-signal-intensity masses are noted in both adnexal regions on T2-weighted images. Masses have typical dark signal intensity. Ovarian follicles (arrows) are noted in left adnexal area.

View larger version (115K): [in a new window]   Fig. 6A —35-year-old woman with fibrothecoma. Axial T1-weighted image shows well-defined mass with low signal intensity in pelvic cavity.

View larger version (121K): [in a new window]   Fig. 6B —35-year-old woman with fibrothecoma. On axial T2-weighted image, mass shows markedly heterogeneous signal intensity.

View larger version (108K): [in a new window]   Fig. 6C —35-year-old woman with fibrothecoma. Gadolinium-enhanced fat-suppressed T1-weighted image reveals intense enhancement in most of mass. Some areas of high signal intensity on T2-weighted image are not enhanced, which represent cystic change and edema.

View larger version (183K): [in a new window]   Fig. 7A —60-year-old woman with torsion of left ovarian fibroma. She presented with aggravation of back pain. Sagittal (A) and axial (B) T2-weighted images show well-circumscribed solid mass with heterogeneous dark signal intensity in left adnexal region. Increased signal intensity area of anterior aspect of mass represents edema. Note whorled structure (arrows) abutting anterior margin of ovarian mass, finding that suggests twisted vascular pedicle.

View larger version (172K): [in a new window]   Fig. 7B —60-year-old woman with torsion of left ovarian fibroma. She presented with aggravation of back pain. Sagittal (A) and axial (B) T2-weighted images show well-circumscribed solid mass with heterogeneous dark signal intensity in left adnexal region. Increased signal intensity area of anterior aspect of mass represents edema. Note whorled structure (arrows) abutting anterior margin of ovarian mass, finding that suggests twisted vascular pedicle.

View larger version (143K): [in a new window]   Fig. 7C —60-year-old woman with torsion of left ovarian fibroma. She presented with aggravation of back pain. Axial T1-weighted image shows round homogeneous low-signal-intensity mass.

View larger version (146K): [in a new window]   Fig. 7D —60-year-old woman with torsion of left ovarian fibroma. She presented with aggravation of back pain. After gadolinium administration, mass is faintly enhanced in areas of low signal intensity on T2-weighted image. Ovarian mass proved to be fibroma without any congestion or necrosis at surgery. Torsion of pedicle was 270°.

View larger version (115K): [in a new window]   Fig. 8A —34-year-old woman with sclerosing stromal tumor. She complained of vaginal spotting during ovulation. Axial T1-weighted image shows well-defined pelvic mass with slightly hyperintense peripheral portion (arrows) and irregular central hypointense area.

View larger version (139K): [in a new window]   Fig. 8B —34-year-old woman with sclerosing stromal tumor. She complained of vaginal spotting during ovulation. Axial T2-weighted image revealed mass with marked hyperintense central area and slightly hyperintense periphery (arrows).

View larger version (147K): [in a new window]   Fig. 8C —34-year-old woman with sclerosing stromal tumor. She complained of vaginal spotting during ovulation. Gadolinium-enhanced fat-suppressed T1-weighted image reveals very intense enhancement of periphery of tumor.

View larger version (178K): [in a new window]   Fig. 9A —27-year-old woman with sclerosing stromal tumor. She had menstrual irregularity and lower abdominal discomfort. Sagittal T2-weighted image shows round mass (arrows) protruding from ovary. Mass has homogeneous intermediate signal intensity. Flow voids are also seen between mass and ovary.

View larger version (159K): [in a new window]   Fig. 9B —27-year-old woman with sclerosing stromal tumor. She had menstrual irregularity and lower abdominal discomfort. Gadolinium-enhanced T1-weighted sagittal images show very intense enhancement of mass. At surgery, pedunculated sclerosing stromal tumor from ovary was confirmed.

View larger version (131K): [in a new window]   Fig. 10A —56-year-old woman with poorly differentiated Sertoli-Leydig cell tumor. Axial T1-weighted image shows lobulated solid mass with low signal intensity (arrows).

View larger version (143K): [in a new window]   Fig. 10B —56-year-old woman with poorly differentiated Sertoli-Leydig cell tumor. Axial (B) and sagittal (C) T2-weighted images show multilobulated mass with intermediate signal intensity with multiple tiny high-signal cysts (arrows).

View larger version (159K): [in a new window]   Fig. 10C —56-year-old woman with poorly differentiated Sertoli-Leydig cell tumor. Axial (B) and sagittal (C) T2-weighted images show multilobulated mass with intermediate signal intensity with multiple tiny high-signal cysts (arrows).

View larger version (146K): [in a new window]   Fig. 10D —56-year-old woman with poorly differentiated Sertoli-Leydig cell tumor. After gadolinium administration, fat-suppressed T1-weighted image shows that mass is intensely and heterogeneously enhanced.

View larger version (164K): [in a new window]   Fig. 11A —41-year-old woman with steroid cell tumor. She presented with amenorrhea and weight gain. Laboratory findings revealed elevated testosterone level. Axial T1-weighted image shows small ( 3 cm) ovoid hypointense mass (arrows) in left adnexal region. Ill-defined area of high signal intensity is noted, indicating lipid content.

View larger version (175K): [in a new window]   Fig. 11B —41-year-old woman with steroid cell tumor. She presented with amenorrhea and weight gain. Laboratory findings revealed elevated testosterone level. On T2-weighted image, mass (arrows) is heterogeneously hyperintense.

View larger version (186K): [in a new window]   Fig. 11C —41-year-old woman with steroid cell tumor. She presented with amenorrhea and weight gain. Laboratory findings revealed elevated testosterone level. After gadolinium administration, coronal fat-suppressed T1-weighted image shows tumor (arrows) is very intensely enhanced.

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