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Fibromas occur at all ages but are most frequently seen in middle-aged women.
Meigs syndrome: consists of ovarian fibroma with ascites and a pleural effusion
fibromas are seen in 75% of patients with Gorlin-Goltz (nevoid basal cell carcinoma) syndrome 1
Fibromas are generally asymptomatic and are often detected at palpation during a routine gynecologic examination. Tumors can reach a large size at presentation.
It is composed of spindle cells forming variable amounts of collagen. Sectioning of a fibroma typically reveals a chalky-white surface that has a whorled appearance, similar to that of a uterine fibroid. Areas of edema, occasionally with cyst formation, are also relatively common.
On ultrasound, fibromas most commonly manifest as solid, hypoechoic masses with ultrasound beam attenuation. As such, they may appear similar to a pedunculated subserosal uterine fibroid.
However, the sonographic appearance can be variable, and some tumors can rarely have cystic components.
Fibromas usually manifest as diffuse, slightly hypoattenuating masses with poor, very slow contrast enhancement. Calcification and bilaterality are both uncommon.
T1: usually demonstrate homogeneous low signal intensity
appear as well-circumscribed masses with low signal intensity
may contain scattered hyperintense areas representing edema or cystic degeneration
a band of T2 hypointensity separating the tumor from the uterus on all imaging planes is considered a characteristic feature
T1 C+ (Gd): usually shows heterogeneous enhancement 5
On dynamic contrast-enhanced MRI, enhancement of the fibromas and fibrothecomas is lower than that of myometrium and fibroids
Ovarian fibromas are categorized as O-RADS MRI 2 2.
Treatment and prognosis
Ovarian fibromas are almost always benign 3.
General imaging differential considerations include:
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- 2. Jeong Y, Outwater E, Kang H. Imaging Evaluation of Ovarian Masses. Radiographics. 2000;20(5):1445-70. doi:10.1148/radiographics.20.5.g00se101445 - Pubmed
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- 5. Shinagare A, Meylaerts L, Laury A, Mortele K. MRI Features of Ovarian Fibroma and Fibrothecoma With Histopathologic Correlation. AJR Am J Roentgenol. 2012;198(3):W296-303. doi:10.2214/ajr.11.7221 - Pubmed