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Objective To compare the MRI features of ovarian thecoma-fibroma and adult-type ovarian granulosa cell tumor (OGCT),and to investigate the differential value of MRI.Methods 13 patients (8 cases of ovarian thecoma-fibroma,5 cases of adult-type OGCT)confirmed by pathology were collected,in which MRI findings were analyzed retrospectively.Results 13 lesions were all unilateral.The shape of more lesions appeared round or oval,and huge lesions were lobulated.Most tumors were dominant solid and well-defined borders.The length-diameter of ovarian thecoma-fibromas ranged from 23 to 268 mm,with the mean diameter of (124±84)mm;on T1WI the solid part of tumors showed equal signal in 5 cases,slight lower signal in 3 cases,on T2WI all tumors were heterogeneous signal,6 lesions appeared equal signal with obscure nebulous high signal;all of 8 lesions were enhanced slightly;4 cases were accompanied with pelvic effusion and other type tumors of the ovarian.The length-diameter of adult-type OGCT tumors ranged from 27 to 110 mm, with the mean diameter of (84±33)mm;the solid part of lesions showed slight lower signal on T1WI and high signal on T2WI,the honeycomb and fissure cystic areas were found in all tumors,4 cases were accompanied with hemorrhage;all tumors were enhanced from moderately to highly,and delay contrast enhancement;the cases were accompanied with endometrial hyperplasia in 3 cases,endometrial carcinoma in 1 case.The non-enhanced cystic areas of two groups of tumors showed lower signal on T1WI and high signal on T2WI. Conclusion There are different characteristics between ovarian thecoma-fibroma and adult-type OGCT on MRI findings,which are helpful to the differential diagnosis.
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Objective To study the CT and MRI features of ovarian granulosa cell tumor(OGCT).Methods The clinical and imaging data of 12 cases with OGCT proved by pathology were analyzed retrospectively(10 cases were performed with CT,5 cases were performed with MRI,and 3 cases were performed with both CT and MRI).Results All lesions were solitary.The tumors presented round,oval, or lobulated with clear boundary.In 12 cases, 3 cases were multiple cystic masses with uneven thickness of cyst walls and septation.Mild enhancement of the cyst walls and septation was showed after contrast enhancement.7 cases were cystic and solid masses with multiple cysts, typically with sponge-like pattern,and most cases showed slightly to moderately enhancement.2 cases were solid mass with septation,1 case showed significant enhancement,and 1 case showed slightly enhancement.6 of 12 cases presented enlargement of the utreus and endometrium thickening,1 case was associated with endometrial carcinoma.Conclusion OGCT has characteristic CT and MRI features, and CT and MRI examinations combined with estrogen abnormality are helpful for diagnosis.
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McCune-Albright syndrome, which consists of cafe-au lait spots, multiple fibrous dysplasia, sexual precocity and endocrinal dysfunction such as pituitary, thyroid and adrenal aberrations, has been increasingly recognized recently. The etiology is now suggested that activating mutations on the gene that encodes the alpha subunit of stimulatory G protein cause McCune-Albright syndrome. The child presented with sexual precocity and elevated estrogen level was still persisted after left oophorectomy and right partial oophorectomy due to misdiagnosed as ovarian granulosa-theca cell tumor. Whole body bone scan revealed abnormal radiotracer uptake on left facial bone and left proximal femur. Facial bone MRI showed marked thickening of facial bone from fibrous dysplasia. And the patient had cafe-au-lait pigmentations on neck and buttock area. Other endocrine function was normal. Pathologic finding of ovary was finally confirmed with cystic follicles. Skull biopsy revealed fibrous dysplasia. And she was finally diagnosed McCune-Albright syndrome.