Figure 10b. Granulosa cell tumor in a 65-year-old woman with abnormal genital bleeding and an estradiol level of 36 pg/mL (normal level, <16 pg/mL). (a) Sagittal T2-weighted image shows that the uterus is slightly enlarged for the patient’s age with thickened endometrium (arrowheads). A subserosal leiomyoma (arrows) is present in the anterior wall. A large ovarian tumor with multiple cystic components is present anterior to the uterus. (b) Sagittal contrast-enhanced T1-weighted image shows marked enhancement of the endometrium (arrowheads), which is indicative of cystic hyperplasia. The ovarian wall and septa also demonstrate marked enhancement. The estradiol level returned to normal after surgery. Histologic examination demonstrated a granulosa cell tumor.