Imaging characteristics of ovarian sclerosing stromal tumor

Abstract

Objectives To evaluate the specific imaging features of ovarian sclerosing stromal tumor (SST), improve its accuracy and specificity of imaging diagnosing, and prevent overestimation of malignancy and reduce unnecessary surgical procedures.Methods Eight patients with magnetic resonance imaging (MRI) and six with computed tomography (CT) images were analyzed in this retrospectively observational study. All cases were confirmed by postoperative pathological examination as ovarian SST. Imaging and pathological features were analyzed.Results All the 14 masses were showed cystic and solid components with outer surface of tumors contained a capsular and complete smooth rim. Eight tumors of MRI showed “lake-island” sign on T2 weighted imaging (T2WI). Two of the 6 CT cases found a flaky calcification. One case showed as a multiloculated cystic mass with irregularly thickened septae and tumor wall. The solid components in other 13 masses are comb- or wheel-like enhanced. After injection of contrast agent, the solid components in 8 cases (57.1%) appeared as early enhancement, while the other 6 cases (42.9%) appeared as progressive enhanced, and the cystic components of all cases had no enhancement in the whole course. Vascular flow signals or/and marked enhancement of blood vessels were found in 12 lesions (85.7%). Pathologic examination demonstrated pseudolobule patterns, round to spindle cells, collagenous areas, edematous hypocellular areas and prominent vasculatures.Conclusions The results demonstrated that MRI with “lake-island” signs on T2WI and MRI/CT dynamic enhencement could play a critical role in making appropriate diagnosis preoperatively.