This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Brown, D. L. Articles by Vella, A. Search for Related Content PubMed PubMed Citation Articles by Brown, D. L. Articles by Vella, A.

Ovarian Stromal Hyperthecosis

Sonographic Features and Histologic Associations

Departments of Radiology (D.L.B., T.L.H.), Pathology (A.C.C.), Obstetrics and Gynecology (S.B.A.H., C.C.C.), and Endocrinology (A.V.), Mayo Clinic, Rochester, Minnesota USA.

Address correspondence to Douglas L. Brown, MD, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 USA., E-mail: brown.douglas{at}mayo.edu

Objective. Ovarian stromal hyperthecosis (SH) has variable clinical importance but can cause hyperandrogenism, particularly in premenopausal women. Sonography is often used to evaluate the ovaries of women with hyperandrogenism, but there is little published regarding the sonographic appearance of SH. The primary purpose of this study was to describe the sonographic features of SH. Methods. A computerized search of our institution’s pathology and imaging databases from 1996 through 2007 was performed to identify patients with histologically proven SH who had pelvic sonography before surgery. Sonograms and histologic findings were reviewed in each case. Results. Twenty ovaries with SH were identified, occurring in 14 patients with a mean age of 59.8 years (range, 36–83 years). The SH was bilateral in 6 patients, unilateral in 6, and of uncertain laterality in 2 with a unilateral oophorectomy. Sonographic findings were as follows: 5 normal, 1 with a hemorrhagic cyst (later resolved) and otherwise normal, 3 enlarged but otherwise normal, 1 with a solid mass due to the nodular form of SH, 1 with a solid mass due to a fibroma, 2 with polycystic ovaries, and 7 not seen. Six of the 14 patients (43%) also had an ovarian fibrothecoma. Conclusions. Ovarian SH has variable sonographic features. Most commonly, the affected ovaries are either normal or slightly enlarged. A solid mass may infrequently be visible, and polycystic ovary syndrome changes may coexist with SH. A possible association of SH with fibrothecoma was also noted, which to our knowledge has not been previously reported.

Key Words: hyperandrogenism • hyperthecosis • ovary • sonography • stroma

Abbreviations: PCO, polycystic ovary • PCOS, polycystic ovary syndrome • SH, stromal hyperthecosis

This article has been cited by other articles:

				P. Rousset, D. Vadrot, J.-N. Buy, D. L. Brown, A. C. Clayton, and A. Vella What Is the Role of Sonography in the Diagnosis of Ovarian Hyperthecosis? * Reply J. Ultrasound Med., August 1, 2009; 28(8): 1123 - 1124. [Full Text] [PDF]