Sclerosing stromal tumor – ovary

Sclerosing  stromal tumor
  • These are benign stromal tumors of ovary
  • Age –present in 2nd and 3rd decades of life
  • This tumor is associated with evidence of estrogen or androgen secretion or both
  • Gross- Unilateral, well circumscribed tumor
  • Cut section– Solid & white but may show areas of cyst formation, edema and foci yellow discolouration
  • Microscopy:
    • Pseudolobular pattern with cellular nodules separated by pauci cellular dense collagenous or edematous tissue
    • Within the nodules prominent thin walled ectatic vessels, varying degree of scleorsis and  disorganised mixture of  fibroblasts and round vacuolated cells, some of which have signet ring morphology are present. These clear cells contain lipid insteadof mucin which is seen in krukenberg tumor
    • Clear cells have eccentrically placed shrunken nuclei
    • Typical lutein cells may be seen in few cases
    • In rare tumor  lutein cells may closely resemble luteinized thecoma
    • Rare tumors may have myxomatous areas
  • Immunohistochemistry: Tumor  cells are reactive for inhibin and or calretinin
  • Differenial Diagnosis:
    • Fibroma
      • These tumors are homogenous appearance and lock pseudolobular patter
    • Krukunberg tumor
      • Tumor cells contain mucin instead of lipid as seen in sclerosing stromal tumor
    • Hemangiopericytoma
      • Though this tumor shows thin walled ecatatic vessels other cell morphology is lacking