Functioning Ovarian Tumors

Figure: Coronal reformatted CT image shows a very large mixed cystic/solid mass in the abdomen/pelvis of a 25-year-old woman presenting with hirsutism. On CT, her normal right ovary is not visualized. The left ovary is normal.

Facts

• Several ovarian tumors and tumorlike conditions can produce estrogen or androgen, resulting in signs and symptoms of hyperestrogenism or hyperandrogenism
• Enlarged uterus with thick endometrium can be seen on imaging in patients with hyperestrogenism

Tumors/tumorlike conditions producing hyperandrogenism

• Sertoli-Leydig cell tumor
• Leydig cell tumor
• Gynandoblastoma
• Germ cell tumor (carcinoid)
• Brenner tumor
• Tumorlike conditions (polycystic ovary syndrome, stromal hyperplasia, stromal hyperthecosis, hyperreactio luteinalis, pregnant luteoma)

Tumors producing hyperestrogenism

• Granulosa cell tumor
• Thecoma
• Serous epithelial tumor
• Mucinous epithelial tumor
• Endometrioid tumor

Tumors that can produce either estrogen or androgen

• Metastatic tumor
• Stromal luteoma
• Sclerosing stromal tumor

Our case: Carcinoid tumor of the right ovary.

Reference:

Tanaka YO, Tsunoda H, Kitagawa Y, et al. Functioning ovarian tumors: direct and indirect findings at MR imaging. Radiographics 2004;24:S147-S166.