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Functioning Ovarian Tumors: Direct and Indirect Findings at MR Imaging¹

¹ From the Departments of Radiology (Y.O.T., Y.K., T.U., Y.S.) and Obstetrics and Gynecology (H.T., H.Y.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. Recipient of a Certificate of Merit award for an education exhibit at the 2003 RSNA scientific assembly. Received January 28, 2004; revision requested March 4 and received April 26; accepted May 5. All authors have no financial relationships to disclose. Address correspondence to Y.O.T. (e-mail: ytanaka@md.tsukuba.ac.jp).

There are many kinds of ovarian tumors and tumorlike conditions that produce estrogen or androgen. Magnetic resonance imaging can demonstrate not only ovarian tumors but also an enlarged uterus with a thick endometrium, even in cases of a clinically latent excess of estrogen. These clinical and indirect imaging findings can aid in the differential diagnosis of ovarian tumors. Granulosa cell tumor and thecoma are well-known estrogen-producing tumors. In pediatric or postmenopausal patients, they manifest as precocious pseudopuberty or postmenopausal bleeding, respectively. Conversely, Sertoli-Leydig cell tumor is representative of hormone-producing tumors that cause virilization. However, there are other functioning ovarian tumors besides the sex cord–stromal tumors. It is well known that metastatic ovarian tumors often have androgen-producing stroma and that mucinous cystadenoma sometimes produces estrogens. Most other ovarian tumors can produce sexual hormones in their stroma. In addition, some endocrinologic abnormalities (eg, polycystic ovary syndrome) also cause virilization.

© RSNA, 2004

Index Terms: Hormones • Ovary, neoplasms, 852.30 • Uterus, abnormalities, 854.30, 854.50

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