Ovarian fibromas and fibrothecomas sonographic correlation with computed tomography and magnetic resonance imaging: A 5-year single-institution experience

Philip Yen, Kathleen Khong, Ramit Lamba, Michael T Corwin, Eugenio O Gerscovich

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives:-To evaluate imaging characteristics of ovarian fibromas and fibrothecomas and to identify select clinical markers and imaging features to help in their diagnosis. Methods-Over a 5-year period, 18 of 29 women with histologically proven fibromas or fibrothecomas underwent sonography, computed tomography (CT), or magnetic resonance imaging (MRI). On review of the images, tumor size, solid component characteristics, and cystic components were evaluated. Age, cancer antigen 125 (CA-125), and Meig syndrome were assessed. Results-Eleven fibrothecomas and 7 fibromas were evaluated. Sonography was performed for 15 tumors, CT for 9, and MRI for 6. Mean age was 52.6 (range, 13-82) years. Mean tumor size was 8.8 (range, 2-18) cm. Seventy-two percent of the tumors were solid, and 28% had cystic components. On sonography, the solid components were isoechoic or hypoechoic compared to the uterus. On CT with contrast, 2 of 8 lesions (25%) showed enhancement. On T1-weighted MRI, 5 lesions (83%) showed an isointense signal, and 1 (17%) showed a hyperintense signal compared to the myometrium. On T2-weighted MRI, 4 of 6 lesions (67%) were hypointense; 1 (16.5%) was isointense; and 1 (16.5%) was hyperintense. Elevated CA-125 was present in 5 of 29 patients (28%). One had Meig syndrome. Conclusions-For a cystic adnexal mass where the primary consideration is commonly an epithelial tumor, the possibility of a cystic stromal tumor should also be considered. Unlike previous studies reporting both T1 and T2 hypointensity, fibrothecomas and fibromas can also show T1 and T2 isointensity and, exceptionally, hyperintensity. Vascularity, shown by Doppler flow and MRI and CT enhancement, is a characteristic of some fibromas and fibrothecomas. Although CA-125 is elevated in some patients, a true correlation is difficult to assess. Meig syndrome is infrequent.

Original languageEnglish (US)
Pages (from-to)13-18
Number of pages6
JournalJournal of Ultrasound in Medicine
Volume32
Issue number1
StatePublished - Jan 1 2013

Fingerprint

Tomography
Magnetic Resonance Imaging
Fibroma
Neoplasms
Ultrasonography
Antigens
Ovarian Fibromata
Myometrium
Uterus
Biomarkers

Keywords

  • Computed tomography
  • Fibroma
  • Fibrothecoma
  • Magnetic resonance imaging
  • Ovarian neoplasms
  • Sonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Medicine(all)

Cite this

@article{66a9b5dca2c6498c94d7886ff2013021,
title = "Ovarian fibromas and fibrothecomas sonographic correlation with computed tomography and magnetic resonance imaging: A 5-year single-institution experience",
abstract = "Objectives:-To evaluate imaging characteristics of ovarian fibromas and fibrothecomas and to identify select clinical markers and imaging features to help in their diagnosis. Methods-Over a 5-year period, 18 of 29 women with histologically proven fibromas or fibrothecomas underwent sonography, computed tomography (CT), or magnetic resonance imaging (MRI). On review of the images, tumor size, solid component characteristics, and cystic components were evaluated. Age, cancer antigen 125 (CA-125), and Meig syndrome were assessed. Results-Eleven fibrothecomas and 7 fibromas were evaluated. Sonography was performed for 15 tumors, CT for 9, and MRI for 6. Mean age was 52.6 (range, 13-82) years. Mean tumor size was 8.8 (range, 2-18) cm. Seventy-two percent of the tumors were solid, and 28{\%} had cystic components. On sonography, the solid components were isoechoic or hypoechoic compared to the uterus. On CT with contrast, 2 of 8 lesions (25{\%}) showed enhancement. On T1-weighted MRI, 5 lesions (83{\%}) showed an isointense signal, and 1 (17{\%}) showed a hyperintense signal compared to the myometrium. On T2-weighted MRI, 4 of 6 lesions (67{\%}) were hypointense; 1 (16.5{\%}) was isointense; and 1 (16.5{\%}) was hyperintense. Elevated CA-125 was present in 5 of 29 patients (28{\%}). One had Meig syndrome. Conclusions-For a cystic adnexal mass where the primary consideration is commonly an epithelial tumor, the possibility of a cystic stromal tumor should also be considered. Unlike previous studies reporting both T1 and T2 hypointensity, fibrothecomas and fibromas can also show T1 and T2 isointensity and, exceptionally, hyperintensity. Vascularity, shown by Doppler flow and MRI and CT enhancement, is a characteristic of some fibromas and fibrothecomas. Although CA-125 is elevated in some patients, a true correlation is difficult to assess. Meig syndrome is infrequent.",
keywords = "Computed tomography, Fibroma, Fibrothecoma, Magnetic resonance imaging, Ovarian neoplasms, Sonography",
author = "Philip Yen and Kathleen Khong and Ramit Lamba and Corwin, {Michael T} and Gerscovich, {Eugenio O}",
year = "2013",
month = "1",
day = "1",
language = "English (US)",
volume = "32",
pages = "13--18",
journal = "Journal of Ultrasound in Medicine",
issn = "0278-4297",
publisher = "American Institute of Ultrasound in Medicine",
number = "1",

}

TY - JOUR

T1 - Ovarian fibromas and fibrothecomas sonographic correlation with computed tomography and magnetic resonance imaging

T2 - A 5-year single-institution experience

AU - Yen, Philip

AU - Khong, Kathleen

AU - Lamba, Ramit

AU - Corwin, Michael T

AU - Gerscovich, Eugenio O

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Objectives:-To evaluate imaging characteristics of ovarian fibromas and fibrothecomas and to identify select clinical markers and imaging features to help in their diagnosis. Methods-Over a 5-year period, 18 of 29 women with histologically proven fibromas or fibrothecomas underwent sonography, computed tomography (CT), or magnetic resonance imaging (MRI). On review of the images, tumor size, solid component characteristics, and cystic components were evaluated. Age, cancer antigen 125 (CA-125), and Meig syndrome were assessed. Results-Eleven fibrothecomas and 7 fibromas were evaluated. Sonography was performed for 15 tumors, CT for 9, and MRI for 6. Mean age was 52.6 (range, 13-82) years. Mean tumor size was 8.8 (range, 2-18) cm. Seventy-two percent of the tumors were solid, and 28% had cystic components. On sonography, the solid components were isoechoic or hypoechoic compared to the uterus. On CT with contrast, 2 of 8 lesions (25%) showed enhancement. On T1-weighted MRI, 5 lesions (83%) showed an isointense signal, and 1 (17%) showed a hyperintense signal compared to the myometrium. On T2-weighted MRI, 4 of 6 lesions (67%) were hypointense; 1 (16.5%) was isointense; and 1 (16.5%) was hyperintense. Elevated CA-125 was present in 5 of 29 patients (28%). One had Meig syndrome. Conclusions-For a cystic adnexal mass where the primary consideration is commonly an epithelial tumor, the possibility of a cystic stromal tumor should also be considered. Unlike previous studies reporting both T1 and T2 hypointensity, fibrothecomas and fibromas can also show T1 and T2 isointensity and, exceptionally, hyperintensity. Vascularity, shown by Doppler flow and MRI and CT enhancement, is a characteristic of some fibromas and fibrothecomas. Although CA-125 is elevated in some patients, a true correlation is difficult to assess. Meig syndrome is infrequent.

AB - Objectives:-To evaluate imaging characteristics of ovarian fibromas and fibrothecomas and to identify select clinical markers and imaging features to help in their diagnosis. Methods-Over a 5-year period, 18 of 29 women with histologically proven fibromas or fibrothecomas underwent sonography, computed tomography (CT), or magnetic resonance imaging (MRI). On review of the images, tumor size, solid component characteristics, and cystic components were evaluated. Age, cancer antigen 125 (CA-125), and Meig syndrome were assessed. Results-Eleven fibrothecomas and 7 fibromas were evaluated. Sonography was performed for 15 tumors, CT for 9, and MRI for 6. Mean age was 52.6 (range, 13-82) years. Mean tumor size was 8.8 (range, 2-18) cm. Seventy-two percent of the tumors were solid, and 28% had cystic components. On sonography, the solid components were isoechoic or hypoechoic compared to the uterus. On CT with contrast, 2 of 8 lesions (25%) showed enhancement. On T1-weighted MRI, 5 lesions (83%) showed an isointense signal, and 1 (17%) showed a hyperintense signal compared to the myometrium. On T2-weighted MRI, 4 of 6 lesions (67%) were hypointense; 1 (16.5%) was isointense; and 1 (16.5%) was hyperintense. Elevated CA-125 was present in 5 of 29 patients (28%). One had Meig syndrome. Conclusions-For a cystic adnexal mass where the primary consideration is commonly an epithelial tumor, the possibility of a cystic stromal tumor should also be considered. Unlike previous studies reporting both T1 and T2 hypointensity, fibrothecomas and fibromas can also show T1 and T2 isointensity and, exceptionally, hyperintensity. Vascularity, shown by Doppler flow and MRI and CT enhancement, is a characteristic of some fibromas and fibrothecomas. Although CA-125 is elevated in some patients, a true correlation is difficult to assess. Meig syndrome is infrequent.

KW - Computed tomography

KW - Fibroma

KW - Fibrothecoma

KW - Magnetic resonance imaging

KW - Ovarian neoplasms

KW - Sonography

UR - http://www.scopus.com/inward/record.url?scp=84871769394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871769394&partnerID=8YFLogxK

M3 - Article

C2 - 23269706

AN - SCOPUS:84871769394

VL - 32

SP - 13

EP - 18

JO - Journal of Ultrasound in Medicine

JF - Journal of Ultrasound in Medicine

SN - 0278-4297

IS - 1

ER -