Ovarian stromal tumors with minor sex cord elements: a report of seven cases.

Seven ovarian tumors that were predominantly stromal, but contained, in addition, a minor component of sex cord elements, were encountered in patients ranging from 16 to 65 years of age. The tumors varied from 1 to 10 cm in diameter and resembled grossly fibromas or thecomas. On microscopical examination they were predominantly fibromatous, but also contained small nests or tubules composed of cells resembling granulosa cells, Sertoli cells, or indifferent cells of sex cord type. Two tumors also had cells of steroid-hormone-cell type; these cells contained crystalloids of Reinke in one case. These two tumors were classified as luteinized thecoma and stromal-Leydig cell tumor with minor sex cord elements. The other five tumors were designated fibromas with minor sex cord elements. Five-year follow-up, available in three cases, revealed no evidence of recurrence after operative removal. Although the presence of sex cord components has generally resulted in the classification of an ovarian tumor in either the granulosa cell or Sertoli-Leydig cell category, we propose that tumors with only minor sex cord components be placed in a separate category.