Ovarian thecoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Pelvic pain and uterine bleeding.

Patient Data

Age: 65 years
Gender: Female
ct

A 60× 55 mm well-defined solid mass with heterogenous enhancement is noted in the right adnexa. The right ovary couldn't be defined separately from the mentioned mass. Mild endometrial thickening is also evident.

The hepatic attenuation value is less than that of the spleen, suggesting fatty liver disease.

Several gas-containing stones are seen in the gallbladder.

A 25mm simple cortical cyst is noted in the upper pole of the right kidney.

In imaged portions of the lower thorax, an 88×54mm well-defined mass with areas of fat density is noted in the right breast, most consistent with hamartoma.

Case Discussion

The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, and histopathology evaluation confirms ovarian thecoma, a benign ovarian tumor of sex cord / stromal (mesenchymal) origin. They typically present in older women in the postmenopausal period and secrete estrogen. It is important to know that more than 20% of ovarian thecomas have concurrent endometrial carcinoma.

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