Sclerosing stromal tumor of the ovary

Last revised by Dr Bahman Rasuli on 24 Nov 2020

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 9.

It occurs predominantly in young women and its incidence peaks around the 2nd to 3rd decades of life 1,2.

Patients may have menstrual irregularity and/or pelvic pain 4. It is usually hormonally inactive, but it may occasionally have an oestrogenic effect (even more rarely an androgenic effect).

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 3.

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 5

Described signal characteristics include 5:

  • 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 7,8 of the lesion which consists of low-intensity nodules set against high-intensity stroma on T2-weighted images 7
  • T1 C+ (Gd): dynamic imaging may show marked early enhancement of the solid components 5,7

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Cases and figures

  • Case 1: gross pathology
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  • Case 1
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