51. Hypervascularized solid ovarian tumor, what a good surprise: ovarian sclerosing stromal tumor

Background

Sclerosing stromal tumor (SST) is a rare benign sex cord-stromal tumor (SCST) of the ovary, accounting for less than 5% of all ovarian SCST cases. We aim to present a case where a solid ovarian tumor, initially suspected as malignant due to imaging findings, was ultimately diagnosed as a benign SST in a postmenarcheal adolescent.

Case

A 14-year-old girl with a history of medulloblastoma, treated with chemotherapy and radiotherapy, was under endocrine care for severe short stature. A pelvic ultrasound revealed a solid, homogeneous, hypervascularized tumor in the left ovary (18 cc), without cystic areas or calcifications. CT confirmed a well-defined, hyperenhancing mass (27 × 49 × 32 mm) in the left adnexa, displacing nearby structures. Tumor markers were negative: LDH 285 U/L, BhCG < 2.4 mIU/mL, Alpha Feto protein < 2 ng/mL, Anti-Mullerian hormone 0.77 ng/mL, Ca 125 32.8 U/mL, Ca 19-9 20.7 U/mL, CEA 2.7 ng/mL. Laparoscopic left adnexectomy was performed, and histopathology confirmed an ovarian SST. The patient's recovery was favorable, and no malignancy was detected. This case was reviewed and approved by the Ethics Committee of Hospital Dr. Luis Calvo Mackenna.

Comments

Despite the low incidence of SST, particularly in young girls, its clinical and imaging findings can mimic malignancy. This case underscores the importance of imaging and histopathology for diagnosis. MRI may help identify benign features and avoid overtreatment, preserving fertility. The benign nature of the tumor provided reassurance to the patient and her family. Financial Disclosure: The authors have no financial relationships relevant to this case to disclose.