Adult ovarian granulosa cell tumors: Spectrum of sonographic and CT findings with pathologic correlation

OBJECTIVE. The objective of this study was to evaluate the spectrum of sono graphic and CT findings in adult ovarian granulosa cell tumors with patholo gic correlation. MATERIALS AND METHODS. Transabdominal sonograms and CT scans in 13 patients with pathologically proven adult ovarian granulosa cell tumors were retros pectively reviewed. Morphologic characteristics of the lesions shown on son ography and CT were correlated with the histopathologic findings. RESULTS. On the basis of sonographic and CT findings, 13 cases of adult ova rian granulosa cell tumor were categorized into five morphologic patterns: multilocular cystic (n = 6), thick-walled unilocular cystic (n = 2), thin-w alled unilocular cystic (n = 1), homogeneously solid (n = 2), and heterogen eously solid (n = 2) masses. Histopathologically, the multilocular cystic m asses were characterized by a predominately macrofollicular pattern of gran ulosa cells and multiple cystic spaces with watery fluid or hemorrhage. Uni locular central cystic masses seen on CT correlated pathologically with con fluence and expansion of the cystic spaces. Homogeneously solid masses seen on sonography and CT were correlated with evenly distributed trabecular or diffuse patterns in the tumor cells. Intratumoral bleeding, infarcts, fibr ous degeneration, and irregularly arranged tumor cells yielded heterogeneou sly solid tumors. CONCLUSION. Adult ovarian granulosa cell tumors have a varied histologic ap pearance and a varied arrangement of tumor cells, both of which can create a spectrum of imaging manifestations. Appreciation of these manifestations is helpful in the diagnosis of this tumor.