Diagnostic Ultrasound - Abdomen and Pelvis

Sex Cord-Stromal Tumor
(Left) Sagittal endovaginal
ultrasound in a 33-year-old
woman with a granulosa cell
tumor shows a right ovarian
mass ſt that is solid but with
numerous small cystic spaces,
exhibiting a Swiss cheese
appearance. (Right) Axial
T1WI C+ FS MR in a 55-yearold
postmenopausal woman
shows a left ovarian mass ſt
displaying enhancement and
containing small cystic spaces.
Cystic changes are also seen
within the thickened
endometrium st. Endometrial
hyperplasia associated with a
left ovarian granulosa cell
tumor was found.
Diagnoses: Female Pelvis
(Left) Endovaginal US in a 38-
year-old woman with a Sertoli-
Leydig cell tumor shows a
solid adnexal mass with
multiple small and mediumsized
cystic spaces. Note the
lack of papillary projections
and closely packed cystic
spaces differentiating this
from an epithelial tumor.
(Right) CECT of the upper
abdomen in the same patient
shows a large right pleural
effusion ſt in the setting of
Meigs syndrome, which most
commonly occurs in
fibrothecomas but can also
occur in other tumors, such as
Sertoli-Leydig.
(Left) Transabdominal US
shows a hypoechoic adnexal
mass with some internal
echoes and no Doppler flow. It
is unclear if this is a cystic
mass, such as endometrioma,
or a solid mass based on this
single image. (Courtesy A.
Kamaya, MD.) (Right) Coronal
T2WI in the same patient
shows the left adnexal mass
ſt to be very hypointense,
similar to the intramural
fibroid . T1WI (not shown)
shows similar hypointensity
and after contrast the lesion is
hypoenhancing. This is typical
of a fibrothecoma. (Courtesy
A. Kamaya, MD.)
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