case_images: PMC10794047_01
case_images: CT and MRI findings of ovarian fibrothecoma with minor sex cord elements. a Unenhanced CT indicating a relatively well-circumscribed mass measured 10 x 10 cm in diameter demonstrating isodensity mixed with hypodensity (arrow) with the skeletal muscle, in the pelvis. Axial (b) and sagittal (c) T2WI displaying a 9 x 10-cm well-defined mass as hypointense and hyperintense mixed (arrow). Dynamic gadolinium-enhanced fat-suppressed T1WI indicated mild enhancement of the peripheral area (arrow) in the early phase (d) and increased enhancement in the delayed phase (e). The central area with enhancement (curved arrow) reflected the abundant intratumoral vessels. f DWI at a b-factor of 800 s mm-2, the tumor revealed heterogeneously high signal intensity (arrow) corresponding to the peripheral enhanced area.
case_images: cro-2024-0017-0001-534798_F01.jpg
case_images: PMC10794047_01_cro-2024-0017-0001-534798_F01.jpg
case_images: F1
case_images: On unenhanced computed tomography (CT), a 10 x 10-cm mass demonstrating isodensity mixed with hypodensity with the skeletal muscle was observed at the center of the pelvis (Fig. 1a). On MRI, the mass was well circumscribed and revealed isointensity compared to the skeletal muscle on T1-weighted imaging (T1WI) and low signal intensity mixed with high signal ranges (arrows) on T2-weighted imaging (T2WI) (Fig. 1b, c).
case_images: Pathological findings of ovarian fibrothecoma with minor sex cord elements. a The mass measures 104 x 96 mm in diameter, and the cut section was white to light yellow in color. The sex cord elements are observed in the peripheral part of the mass (arrow). b Microphotogragh displaying fibroblast cells and theca cells (hematoxylin-eosin). c Sex cord-type cells with oval nucleus and minimal cytoplasm, comprising <1% of total tumor area, demonstrate a tubular structure and palisading arrangement (hematoxylin-eosin). The sex cord elements demonstrating immunoreactivity with calretinin (d) and inhibin-alpha (e) (immunohistochemistry).
case_images: cro-2024-0017-0001-534798_F02.jpg
case_images: PMC10794047_01_cro-2024-0017-0001-534798_F02.jpg
case_images: F2
case_images: T1WI, the mass was continuous with the right ovarian artery and vein, suggesting that it originated from the right ovary and indicated mild enhancement of the peripheral area in the early phase and increased enhancement in the delayed phase (arrows) (Fig. 2d, e). The central area with enhancement reflected the abundant intratumoral vessels (curved arrow). Diffusion-weighted imaging (DWI) at a b-factor of 800 s mm-2, the tumor revealed heterogeneously high signal intensity corresponding to the peripheral enhanced area (arrow) (Fig. 2f), and the apparent diffusion coefficient values of the high-intensity areas on DWI were 0.60-080 x 10-3 mm2 s-1. Pathological examination revealed a mass measuring 104 x 96 mm in diameter, and the cut section was white to light yellow in color (Fig. 2a). Microscopic examination revealed features of a fibrothecoma with minor sex cord elements (Fig. 2b, c). The sex cord cell aggregates with dense proliferation and angiogenesis resembling Sertoli-stromal cell aggregates were scattered at the peripheral sites of the mass and focally immunoreactive for calretinin (Fig. 2d) and inhibin-alpha (Fig. 2e), suggesting sex cord-stromal and fibrous neoplasms.