Sclerosing stromal tumor of the ovary
Sclerosing stromal tumor (SST) of the ovary is a rare ovarian neoplasm. It is considered a subtype of ovarian sex cord / stromal tumor and is included in the fibroma-thecoma group of ovarian tumors .
Epidemiology
It occurs predominantly in young women and its incidence peaks around the 2 to 3 decades of life .
Clinical presentation
Patients may have menstrual irregularity and/or pelvic pain . It is usually hormonally inactive, but it may occasionally have an oestrogenic effect (even more rarely an androgenic effect).
Pathology
It is histologically characterized by cellular heterogeneity, prominent vasculature, and a pseudolobular appearance composed of cellular and hypocellular areas. They generally tend to be unilateral .
Radiographic features
Ultrasound
Described sonographic features (whilst being nonspecific) include tumor with multilocular cystic components and irregularly thickened septa and tumor walls or a solid tumor including several small cystic components .
Pelvic MRI
Described signal characteristics include :
- T2
- signal intensities of the cystic components are high and those of the solid components were inhomogeneous, ranging from intermediate-high to high
- MR may show pseudolobulation of the lesion which consists of low-intensity nodules set against high-intensity stroma on T2-weighted images
- T1 C+ (Gd): dynamic imaging may show marked early enhancement of the solid components
Differential Diagnosis
- Krukenberg tumor: usually occur in the 6 and 7 decades of life and often bilateral
- other sex cord stromal tumors: like fibroma and thecoma
- non-neoplastic conditions: like massive ovarian edema
See also
