Fact-sheet: Ovarian fibroma
Updated on 02/26/2021 at 3:17 PM
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Definition
Rare ovarian thecal tumor, well-defined, encapsulated
Associated in 1 to 10% of cases with hydrothorax and ascites, constituting Meigs syndrome
Ultrasound
First-line examination.
Performed via the suprapubic approach (full bladder) then transvaginally (empty bladder), except in case of contraindication (virgin patient, recent postoperative setting).
Lateral uterine mass, rather hypoechoic with posterior acoustic enhancement.
MRI
Second-line examination complementary to transvaginal ultrasound.
Standard MRI protocol for the evaluation of a pelvic mass:
- 3 T2 planes centered on the pelvis
- axial T2 lumbo-aortic (lymph nodes)
- axial diffusion
- axial T1 Dixon
- dynamic T1 study before and after gadolinium injection
--> Adnexal mass:
- solid (= pure solid with enhancement)
- well-defined, a few centimeters in size (3-4)
- T2 hypointense related to its prominent thecal component, T1 hypointense, heterogeneous on diffusion
- type 1 enhancement curve (very slow and progressive rise due to weak enhancement)
Differential diagnosis
Fibrothecoma (histologic subtype richer in lipids)
Brenner tumor: T2 hypointense but with a type 2 curve
Subserosal uterine leiomyoma