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Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison

View Article: PubMed Central - PubMed

ABSTRACT

Background: Ovarian thecoma-fibroma groups (OTFG) are uncommon sex cord-stromal neoplasms. The objective of the study was to demonstrate clinical and sonographic features of OTFG and compare with surgical histopathology.

Methods: A total of 61 patients with surgically proven OTFG were enrolled in this retrospective study to demonstrate its clinical and sonographic features and to compare with pathological findings. Gray scale and color Doppler sonography were performed presurgically with either transabdominal or transvaginal approach to image pelvic structures and lesions. The clinical findings and sonographic appearances were compared with the types of the OTFG tumors based on the histopathological diagnosis.

Results: The mean patient age was 53.57 (range, 26–86) years. There were 63.93% (39/61) patients in postmenopausal and 63.93% (39/61) patients with no clinical symptoms. Ultrasound findings of OTFG revealed as solid tumors with a typical feature of well-demarcated hypoechoic masses in 70.49% (43/61), among which 74.41% (32/43) tumors were smaller than 5 cm in diameter. There were 17 mixed echogenic masses with calcification, hemorrhage, or cyst, among which 70.59% (12/17) lesions were larger than 5 cm in diameter. Acoustic attenuation of the tumor was presented in 44.26% (27/61) of the cases. Doppler flow signals within the tumors were found in 20 cases (32.79%), in which 80% (16/20) had minimal or moderate flow signals. Ascites was detected in 32.79% (20/61) of the cases, Megi’s syndrome was found in 1 case. Final pathology revealed 41 (67.21%) thecoma-fibromas, 15 (24.59%) fibromas, 4 (6.56%) thecomas and 1 (1.64%) fibrosarcoma. There were 58 patients underwent cancer antigen 125 (CA125) test, and 20.69% (12/58) showed an elevated level. The diameter of tumors was found to be significantly correlated with CA125 level (p < 0.01) and the amount of ascites fluid (p < 0.05).

Conclusions: The typical sonographic features of OTFG include adnexal hypoechoic masses with clear border and acoustic attenuation as well as minimal Doppler flow signals. All the aforementioned features could make ultrasound imaging as a assistent tool improve the preoperative diagnostic accuracy.

No MeSH data available.


Related in: MedlinePlus

A 53-year-old woman with a pelvic mass discovered by routing physical examination. a On ultrasound examination, a 28 mm*22 mm*26 mm well-circumscribed hypoechoic mass was observed in the right ovary, with posterior echo attenuation. b On laparoscopy surgery, right ovarian was hard and enlarged, the surface smooth, having a good mobility; in the pelvic, a small number of pale yellow ascites were observed. c Pathologically, right ovarian was enlarged, with tough textures and grayish white surfaces. d Pathological findings confirmed thecofibroma in right ovarian
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Fig2: A 53-year-old woman with a pelvic mass discovered by routing physical examination. a On ultrasound examination, a 28 mm*22 mm*26 mm well-circumscribed hypoechoic mass was observed in the right ovary, with posterior echo attenuation. b On laparoscopy surgery, right ovarian was hard and enlarged, the surface smooth, having a good mobility; in the pelvic, a small number of pale yellow ascites were observed. c Pathologically, right ovarian was enlarged, with tough textures and grayish white surfaces. d Pathological findings confirmed thecofibroma in right ovarian

Mentions: Sonographic findings of the neoplasms in 61 patients were presented in Table 1 and Figs. 1 (a, b), 2 (a) and 3 (a). The typical sonographic feature of the OTFG was well-demarcated hypoechoic mass with smooth and clear margin in 70.49% (43/61). The mean diameter of the tumor was 5.86 cm, ranging from 1 ~ 25 cm, Based on preoperative ultrasound features, specific diagnosis of OTFG were correctly made in 72.13% (44/61) cases while 12 (19.67%) cases were misdiagnosed as subserous myoma, 1 (1.64%) as ovarian malignancy, 2 (3.28%) as endometrioma, 1 (1.64%) as complex cyst and 1 (1.64%) as cystadenomas.Table 1


Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison
A 53-year-old woman with a pelvic mass discovered by routing physical examination. a On ultrasound examination, a 28 mm*22 mm*26 mm well-circumscribed hypoechoic mass was observed in the right ovary, with posterior echo attenuation. b On laparoscopy surgery, right ovarian was hard and enlarged, the surface smooth, having a good mobility; in the pelvic, a small number of pale yellow ascites were observed. c Pathologically, right ovarian was enlarged, with tough textures and grayish white surfaces. d Pathological findings confirmed thecofibroma in right ovarian
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5120502&req=5

Fig2: A 53-year-old woman with a pelvic mass discovered by routing physical examination. a On ultrasound examination, a 28 mm*22 mm*26 mm well-circumscribed hypoechoic mass was observed in the right ovary, with posterior echo attenuation. b On laparoscopy surgery, right ovarian was hard and enlarged, the surface smooth, having a good mobility; in the pelvic, a small number of pale yellow ascites were observed. c Pathologically, right ovarian was enlarged, with tough textures and grayish white surfaces. d Pathological findings confirmed thecofibroma in right ovarian
Mentions: Sonographic findings of the neoplasms in 61 patients were presented in Table 1 and Figs. 1 (a, b), 2 (a) and 3 (a). The typical sonographic feature of the OTFG was well-demarcated hypoechoic mass with smooth and clear margin in 70.49% (43/61). The mean diameter of the tumor was 5.86 cm, ranging from 1 ~ 25 cm, Based on preoperative ultrasound features, specific diagnosis of OTFG were correctly made in 72.13% (44/61) cases while 12 (19.67%) cases were misdiagnosed as subserous myoma, 1 (1.64%) as ovarian malignancy, 2 (3.28%) as endometrioma, 1 (1.64%) as complex cyst and 1 (1.64%) as cystadenomas.Table 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Ovarian thecoma-fibroma groups (OTFG) are uncommon sex cord-stromal neoplasms. The objective of the study was to demonstrate clinical and sonographic features of OTFG and compare with surgical histopathology.

Methods: A total of 61 patients with surgically proven OTFG were enrolled in this retrospective study to demonstrate its clinical and sonographic features and to compare with pathological findings. Gray scale and color Doppler sonography were performed presurgically with either transabdominal or transvaginal approach to image pelvic structures and lesions. The clinical findings and sonographic appearances were compared with the types of the OTFG tumors based on the histopathological diagnosis.

Results: The mean patient age was 53.57 (range, 26–86) years. There were 63.93% (39/61) patients in postmenopausal and 63.93% (39/61) patients with no clinical symptoms. Ultrasound findings of OTFG revealed as solid tumors with a typical feature of well-demarcated hypoechoic masses in 70.49% (43/61), among which 74.41% (32/43) tumors were smaller than 5 cm in diameter. There were 17 mixed echogenic masses with calcification, hemorrhage, or cyst, among which 70.59% (12/17) lesions were larger than 5 cm in diameter. Acoustic attenuation of the tumor was presented in 44.26% (27/61) of the cases. Doppler flow signals within the tumors were found in 20 cases (32.79%), in which 80% (16/20) had minimal or moderate flow signals. Ascites was detected in 32.79% (20/61) of the cases, Megi’s syndrome was found in 1 case. Final pathology revealed 41 (67.21%) thecoma-fibromas, 15 (24.59%) fibromas, 4 (6.56%) thecomas and 1 (1.64%) fibrosarcoma. There were 58 patients underwent cancer antigen 125 (CA125) test, and 20.69% (12/58) showed an elevated level. The diameter of tumors was found to be significantly correlated with CA125 level (p < 0.01) and the amount of ascites fluid (p < 0.05).

Conclusions: The typical sonographic features of OTFG include adnexal hypoechoic masses with clear border and acoustic attenuation as well as minimal Doppler flow signals. All the aforementioned features could make ultrasound imaging as a assistent tool improve the preoperative diagnostic accuracy.

No MeSH data available.


Related in: MedlinePlus