Stromal luteoma of the ovary: a clinicopathological analysis of 25 cases

The clinical and pathological features of 25 stromal luteomas were reviewed. The patients ranged in age from 28-74 (average 58.4) years. The most common initial manifestation (60%) was abnormal vaginal bleeding; three patients (12%) were virilized. The tumors, only one of which was bilateral, ranged from 0.25-2.9 (average 1.3) cm in greatest diameter. They were all well circumscribed. Microscopic examination revealed unencapsulated nodules composed of rounded polyhedral cells that were arranged either diffusely or in nests and cords. Twenty percent showed degeneration within aggregates of cell resulting in the formation of pseudoacinar structures. The cytoplasm of the neoplastic cells was generally eosinophilic and granular, and lipochrome granules were present in over half the tumors. In 92% of the cases hyperthecosis was present in the adjacent ovarian stroma. Follow-up of 6 months to 17 years was available for 19 patients. Sixteen of them were alive and free of disease; the remaining three died of other causes. The benign course in all the cases in which follow-up data were available was expected in view of the small size of the tumors and their benign microscopic appearance.