Most occur in adult women, with ~66% in postmenopausal women. Although they account for ~1% of all ovarian tumors 5, they are the most common benign solid ovarian tumor. It represents <2% of pediatric ovarian tumors.
The thecoma component of a fibrothecoma can secrete estrogen, and the patient may present with abnormal vaginal bleeding and endometrial hyperplasia.
They may be seen as a homogeneous hypoechoic mass with posterior acoustic shadowing, although in most cases the sonographic appearance is nonspecific.
The vast majority (~80%) of ovarian fibrothecomas appear as solid masses with a delayed accumulation of contrast medium. On dynamic CT, there is an absence of arterial vessels and absence or slight early uptake of contrast enhancement 3. Calcification may be present and, as these tumors enlarge, myxoid or cystic degeneration may occur, resulting in a heterogeneous pattern 4.
Reported signal characteristics include 1:
- T1: typically shows homogeneous low signal intensity
- lesions show predominantly homogeneous low signal intensity (from fibrous components)
- scattered high signal areas may be present representing areas of cystic degeneration +/- edema
Treatment and prognosis
Most cases are benign and surgical resection is curative.
- 1. Troiano RN, Lazzarini KM, Scoutt LM et-al. Fibroma and fibrothecoma of the ovary: MR imaging findings. Radiology. 1997;204 (3): 795-8. Radiology (abstract) - Pubmed citation
- 2. Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
- 3. Bazot M, Ghossain MA, Buy JN et-al. Fibrothecomas of the ovary: CT and US findings. J Comput Assist Tomogr. 17 (5): 754-9. - Pubmed citation
- 4. Mak CW, Tzeng WS, Chen CY. Computed tomography appearance of ovarian fibrothecomas with and without torsion. Acta Radiol. 2009;50 (5): 570-5. doi:10.1080/02841850902896163 - Pubmed citation
- 5. Hodler J, Schulthess GK, Zollikofer CL. Diseases of the Abdomen and Pelvis 2010-2013, Diagnostic Imaging and Interventional Techniques. Springer. (2010) ISBN:8847016363. Read it at Google Books - Find it at Amazon
- 6. Outwater EK, Wagner BJ, Mannion C et-al. Sex cord-stromal and steroid cell tumors of the ovary. Radiographics. 18 (6): 1523-46. Radiographics (abstract) - Pubmed citation
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