Ovarian Cellular Fibroma: Magnetic Resonance Imaging Findings With Pathological Correlation

Abstract

Ovarian cellular fibromas are relatively rare and generally have a favorable prognosis. However, their recurrence can occur in cases involving rupture or adhesion. Preoperative diagnosis is crucial for determining the surgical approach and tumor retrieval methods. To date, the radiological findings of this tumor have not been well documented in the literature. We report the case of a 60-year-old postmenopausal woman with an ovarian cellular fibroma. Ultrasonography, computed tomography, and magnetic resonance imaging (MRI) revealed an 8 cm solid mass in the left adnexal area with minimal amount of ascites. On T2-weighted imaging (T2WI), the solid portion on the right side of the mass was mildly hyperintense, with the presence of several cystic components, while the smaller solid portion on the left side was hypointense. A diffusion-restricted site was also observed in the right solid portion of the mass. On dynamic contrast-enhanced MRI, the entire solid portion of the mass showed a faint and gradual enhancement pattern, suggesting a fibrous tumor. Since it could not be confidently diagnosed as an observable benign tumor, diagnostic laparoscopic surgery was performed to remove the mass, and following pathological examination of the tumor, a diagnosis of ovarian cellular fibroma was established. Microscopically, most areas of the tumor showed high cellularity, consistent with the diffusion-restricted site observed on MRI. However, some areas of normal density existed. In cases wherein a fibrous ovarian tumor exhibits diffusion restriction, cellular fibroma should be considered. This finding could have the potential to contribute to preoperative diagnosis and aid in the selection of treatment options.

J Clin Gynecol Obstet. 2024;000(000):000-000
doi: https://doi.org/10.14740/jcgo981