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Gynecology
Diagnosis
Ovary
Neoplasms
Sex Cord-Stromal
Fibroma, Thecoma, and Fibrothecoma
Fibroma, Thecoma, and Fibrothecoma
Akram M. Shaaban, MBBCh
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Benign ovarian neoplasms classified as stromal tumors
                • Fibroma is composed of fibroblastic cells within variably collagenous stroma
                • Thecoma is composed predominantly of cells resembling theca cells

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Taylor EC et al: Multimodality imaging approach to ovarian neoplasms with pathologic correlation. Radiographics. 41(1):289-315, 2021
                                          2. Chen H et al: Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison. J Ovarian Res. 9(1):81, 2016
                                          3. Rambocas N et al: Gynecologic implications of Gorlin-Goltz syndrome. Int J Gynaecol Obstet. 123(2):166, 2013
                                          4. Yen P et al: Ovarian fibromas and fibrothecomas: sonographic correlation with computed tomography and magnetic resonance imaging: a 5-year single-institution experience. J Ultrasound Med. 32(1):13-8, 2013
                                          5. Zhang H et al: Value of 3.0 T diffusion-weighted imaging in discriminating thecoma and fibrothecoma from other adnexal solid masses. J Ovarian Res. 6(1):58, 2013
                                          6. Khashper A et al: T2-hypointense adnexal lesions: an imaging algorithm. Radiographics. 32(4):1047-64, 2012
                                          7. Li X et al: Imaging features and pathologic characteristics of ovarian thecoma. J Comput Assist Tomogr. 36(1):46-53, 2012
                                          8. Shinagare AB et al: MRI features of ovarian fibroma and fibrothecoma with histopathologic correlation. AJR Am J Roentgenol. 198(3):W296-303, 2012
                                          9. Wang S et al: Prediction of benignity of solid adnexal masses. Arch Gynecol Obstet. 285(3):721-6, 2012
                                          10. Okajima Y et al: Intracellular lipid in ovarian thecomas detected by dual-echo chemical shift magnetic resonance imaging: report of 2 cases. J Comput Assist Tomogr. 34(2):223-5, 2010
                                          11. Shanbhogue AK et al: Clinical syndromes associated with ovarian neoplasms: a comprehensive review. Radiographics. 30(4):903-19, 2010
                                          12. Paladini D et al: Imaging in gynecological disease (5): clinical and ultrasound characteristics in fibroma and fibrothecoma of the ovary. Ultrasound Obstet Gynecol. 34(2):188-95, 2009
                                          13. Tanaka YO et al: MR findings of ovarian tumors with hormonal activity, with emphasis on tumors other than sex cord-stromal tumors. Eur J Radiol. 62(3):317-27, 2007
                                          14. Kawano Y et al: Magnetic resonance imaging findings in leiomyoma of the ovary: a case report. Arch Gynecol Obstet. 273(5):298-300, 2006
                                          15. Jung SE et al: CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol. 185(1):207-15, 2005
                                          16. Takeshita T et al: Ovarian fibroma (fibrothecoma) with extensive cystic degeneration: unusual MR imaging findings in two cases. Radiat Med. 23(1):70-4, 2005
                                          17. Yoshitake T et al: Bilateral ovarian leiomyomas: CT and MRI features. Abdom Imaging. 30(1):117-9, 2005
                                          18. Chang SD et al: Limited-sequence magnetic resonance imaging in the evaluation of the ultrasonographically indeterminate pelvic mass. Can Assoc Radiol J. 55(2):87-95, 2004
                                          19. Cho SM et al: CT and MRI findings of cystadenofibromas of the ovary. Eur Radiol. 14(5):798-804, 2004
                                          20. Sala EJ et al: Magnetic resonance imaging of benign adnexal disease. Top Magn Reson Imaging. 14(4):305-27, 2003
                                          21. Jung SE et al: CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22(6):1305-25, 2002
                                          22. Schwartz RK et al: Ovarian fibroma: findings by contrast-enhanced MRI. Abdom Imaging. 22(5):535-7, 1997
                                          23. Troiano RN et al: Fibroma and fibrothecoma of the ovary: MR imaging findings. Radiology. 204(3):795-8, 1997
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Benign ovarian neoplasms classified as stromal tumors
                                                        • Fibroma is composed of fibroblastic cells within variably collagenous stroma
                                                        • Thecoma is composed predominantly of cells resembling theca cells

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Taylor EC et al: Multimodality imaging approach to ovarian neoplasms with pathologic correlation. Radiographics. 41(1):289-315, 2021
                                                                                  2. Chen H et al: Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison. J Ovarian Res. 9(1):81, 2016
                                                                                  3. Rambocas N et al: Gynecologic implications of Gorlin-Goltz syndrome. Int J Gynaecol Obstet. 123(2):166, 2013
                                                                                  4. Yen P et al: Ovarian fibromas and fibrothecomas: sonographic correlation with computed tomography and magnetic resonance imaging: a 5-year single-institution experience. J Ultrasound Med. 32(1):13-8, 2013
                                                                                  5. Zhang H et al: Value of 3.0 T diffusion-weighted imaging in discriminating thecoma and fibrothecoma from other adnexal solid masses. J Ovarian Res. 6(1):58, 2013
                                                                                  6. Khashper A et al: T2-hypointense adnexal lesions: an imaging algorithm. Radiographics. 32(4):1047-64, 2012
                                                                                  7. Li X et al: Imaging features and pathologic characteristics of ovarian thecoma. J Comput Assist Tomogr. 36(1):46-53, 2012
                                                                                  8. Shinagare AB et al: MRI features of ovarian fibroma and fibrothecoma with histopathologic correlation. AJR Am J Roentgenol. 198(3):W296-303, 2012
                                                                                  9. Wang S et al: Prediction of benignity of solid adnexal masses. Arch Gynecol Obstet. 285(3):721-6, 2012
                                                                                  10. Okajima Y et al: Intracellular lipid in ovarian thecomas detected by dual-echo chemical shift magnetic resonance imaging: report of 2 cases. J Comput Assist Tomogr. 34(2):223-5, 2010
                                                                                  11. Shanbhogue AK et al: Clinical syndromes associated with ovarian neoplasms: a comprehensive review. Radiographics. 30(4):903-19, 2010
                                                                                  12. Paladini D et al: Imaging in gynecological disease (5): clinical and ultrasound characteristics in fibroma and fibrothecoma of the ovary. Ultrasound Obstet Gynecol. 34(2):188-95, 2009
                                                                                  13. Tanaka YO et al: MR findings of ovarian tumors with hormonal activity, with emphasis on tumors other than sex cord-stromal tumors. Eur J Radiol. 62(3):317-27, 2007
                                                                                  14. Kawano Y et al: Magnetic resonance imaging findings in leiomyoma of the ovary: a case report. Arch Gynecol Obstet. 273(5):298-300, 2006
                                                                                  15. Jung SE et al: CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol. 185(1):207-15, 2005
                                                                                  16. Takeshita T et al: Ovarian fibroma (fibrothecoma) with extensive cystic degeneration: unusual MR imaging findings in two cases. Radiat Med. 23(1):70-4, 2005
                                                                                  17. Yoshitake T et al: Bilateral ovarian leiomyomas: CT and MRI features. Abdom Imaging. 30(1):117-9, 2005
                                                                                  18. Chang SD et al: Limited-sequence magnetic resonance imaging in the evaluation of the ultrasonographically indeterminate pelvic mass. Can Assoc Radiol J. 55(2):87-95, 2004
                                                                                  19. Cho SM et al: CT and MRI findings of cystadenofibromas of the ovary. Eur Radiol. 14(5):798-804, 2004
                                                                                  20. Sala EJ et al: Magnetic resonance imaging of benign adnexal disease. Top Magn Reson Imaging. 14(4):305-27, 2003
                                                                                  21. Jung SE et al: CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22(6):1305-25, 2002
                                                                                  22. Schwartz RK et al: Ovarian fibroma: findings by contrast-enhanced MRI. Abdom Imaging. 22(5):535-7, 1997
                                                                                  23. Troiano RN et al: Fibroma and fibrothecoma of the ovary: MR imaging findings. Radiology. 204(3):795-8, 1997