Diagnostic Ultrasound - Abdomen and Pelvis

Sex Cord-Stromal Tumor
Diagnoses: Female Pelvis
(Left) Transabdominal
ultrasound shows a
hypoechoic solid mass ſt in
the left adnexa with dense
posterior acoustic shadowing.
The ovary was not seen
separately. (Right)
Endovaginal ultrasound in the
same patient shows the
shadowing hypoechoic mass
ſt adjacent to a rim of normal
ovarian tissue st. The imaging
appearance is typical of
fibroma/fibrothecoma.
(Left) Transabdominal
ultrasound shows a large,
homogenously hypoechoic
pelvic mass with no color
Doppler flow in this patient
with a large fibrothecoma.
(Right) Endovaginal
ultrasound in the same patient
shows a solid large mass with
areas of linear refractive
shadowing ſt, similar to that
seen in a fibroid because of
similar histology. A small cyst
representing a normal follicle
is seen at the periphery st.
(Left) Sagittal T2WI in the
same patient from the above
panel shows the large
hypointense fibrothecoma ſt
posterior to the uterus with a
claw of normal hyperintense
ovarian parenchyma st.
(Right) Coronal T1WI post
gadolinium in the same
patient shows
hypoenhancement of the
fibrothecoma ſt. A claw of
normal ovary st is again seen
containing a follicle ,
helping to distinguish this
from a pedunculated fibroid.
Chronic torsion was suspected
given edematous ovarian
parenchyma.
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