MRI findings of ovarian microcystic stromal tumor with pathologic correlation: a case report and literature review.
Mayumi Takeuchi, Kenji Matsuzaki, Yoshimi Bando et al.
✦ AI-curated · Sources linked
Case in brief
A 49-year-old woman had a right ovarian cystic mass with an irregularly thickened wall, raising concern for malignancy. MRI showed hemorrhagic contents, a T2-hyperintense wall divided by thin T2-hypointense septa, rapid intense but inhomogeneous enhancement, and heterogeneous apparent diffusion coefficients without marked diffusion restriction. Histology revealed lobulated stromal cell nests with fibrous septa and microcystic and hemorrhagic changes. Nuclear and cytoplasmic β-catenin staining confirmed ovarian microcystic stromal tumor (MCST), a benign sex cord-stromal tumor.
What made this case unusual
The hemorrhagic cystic appearance and irregularly thickened, enhancing wall mimicked malignancy. Pathologic correlation linked the thin hypointense septa to fibrous stroma and the heterogeneous ADC and cystic changes to tumor-cell dissociation and microcyst formation.
Diagnostic / clinical pearl
In an ovarian mass suspicious for malignancy, thin T2-hypointense septa, a capsule-like compressed cortex, and heterogeneous ADC without marked diffusion restriction may support MCST; correlate imaging with histology and β-catenin immunohistochemistry.
Why it matters
Recognizing these features may help avoid extensive surgery and preserve ovarian function.