May 20, 2009

Functioning Ovarian Tumors

Figure: Coronal reformatted CT image shows a very large mixed cystic/solid mass in the abdomen/pelvis of a 25-year-old woman presenting with hirsutism. On CT, her normal right ovary is not visualized. The left ovary is normal.


Facts
  • Several ovarian tumors and tumorlike conditions can produce estrogen or androgen, resulting in signs and symptoms of hyperestrogenism or hyperandrogenism
  • Enlarged uterus with thick endometrium can be seen on imaging in patients with hyperestrogenism

Tumors/tumorlike conditions producing hyperandrogenism
  • Sertoli-Leydig cell tumor
  • Leydig cell tumor
  • Gynandoblastoma
  • Germ cell tumor (carcinoid)
  • Brenner tumor
  • Tumorlike conditions (polycystic ovary syndrome, stromal hyperplasia, stromal hyperthecosis, hyperreactio luteinalis, pregnant luteoma)
Tumors producing hyperestrogenism
  • Granulosa cell tumor
  • Thecoma
  • Serous epithelial tumor
  • Mucinous epithelial tumor
  • Endometrioid tumor
Tumors that can produce either estrogen or androgen
  • Metastatic tumor
  • Stromal luteoma
  • Sclerosing stromal tumor
Our case: Carcinoid tumor of the right ovary.

Reference:

Tanaka YO, Tsunoda H, Kitagawa Y, et al. Functioning ovarian tumors: direct and indirect findings at MR imaging. Radiographics 2004;24:S147-S166.

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