Sclerosing stromal tumor of the ovary: A case report and review of the literature

Sclerosing stromal ovarian tumor is an extremely rare neoplasm occurring pr edominantly in the second and third decades of life. It presents most often with non-specific symptoms. We describe a new case occurring in a young wo man presenting with infertility and irregular menses. Ultrasound examinatio n showed a left heterogenous ovarian mass without focal calcifications. His tological features included a pseudolobular pattern with focal areas of scl erosis, prominent vascularity and a two-cell population of spindled and pol ygonal cells. Immunohistochemical analysis for actin, vimentin, laminin, va scular epidermal growth factor (VEGF), oestrogen and progesterone receptors using formalin-fixed and paraffin-embedded materials showed predominant po sitivity for a-smooth muscle actin and consistent positivity for laminin an d vimentin. The epidermal VEGF demonstrated rich tumor vascularity. Oestrog en and progesterone receptors were not expressed, suggesting hormonally ind ependent development. Menstrual cycle disturbances, however, were corrected following extirpation of the tumor, indicating some endocrine involvement. In addition, the patient became pregnant ten months after the operation. T he differential diagnosis is discussed.