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Figure 8c. Thecoma in a 17-year-old girl with marked virilization and primary amenorrhea. (a) Axial T2-weighted MR image shows a mixed solid and cystic left ovarian mass; the solid part has marked low signal intensity (arrowheads). (b) Axial T1-weighted MR images obtained before (left) and 120 seconds after (right) contrast material administration show a multilocular cystic component on the ventral side of the tumor; the cystic component is filled with high-signal-intensity fluid (arrow). The solid part of the mass is intensely enhanced during the early phase of the dynamic contrast material study (right). (c) Sagittal T2-weighted MR image shows an atrophic uterus (arrows). The patient also had hirsutism, a hypertrophic clitoris, mild obesity, and deepening of the voice. (d) High-power photomicrograph (H-E stain) of a specimen from the yellowish, predominantly solid tumor removed from the patient. The tumor is composed of oval or round tumor cells and has abundant pale cytoplasm containing lipid within a fibromatous background. The elevated serum testosterone level (113.9 ng/dL [4.0 nmol/L]; normal range, 6-86 ng/dL [0.2-3.0 nmol/L]) decreased immediately after surgery (29.6 ng/dL [1.0 nmol/L]).
