Presentation
Pelvic pain with a solid pelvic mass on ultrasound exam (not shown).
Patient Data
Well-defined lobulated left ovarian mass isointense to the myometrium on T1 and T2 with central areas of high signal on T2 (areas of edema or cystic degeneration). The postcontrast sequences show moderate heterogeneous enhancement.
Normal appearance of the uterus and right ovary.
Mild peritoneal effusion in Douglas pouch.
Case Discussion
MRI features of left ovarian mass in a young patient suggestive of ovarian fibroma.
General imaging differential considerations include:
large pedunculated subserosal uterine leiomyoma
-
thecoma and fibrothecoma
most occur in adult women, with ~66% in postmenopausal women
tend to have brighter signal on T2 given edema and cystic degeneration
contrast-enhancement may be observed given the vascularization of the theca cells
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