Ovary tumor
Sex cord stromal tumors

Author: Shahrzad Ehdaivand, M.D. (see Authors page)

Revised: 6 March 2018, last major update December 2012

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed search: Ovarian thecoma
Cite this page: Ehdaivand, S. Thecoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorthecoma.html. Accessed June 20th, 2018.
Definition / general
  • Usually > 40 years old, 65% after menopause
  • May be hormonally active, associated with estrogenic and occasionally (if steroid cells present) androgenic symptoms
  • Usually benign
  • Luteinized thecomas: thecoma plus features of steroid hormone secreting cells including edema, focal mitotic activity; may be associated with sclerosing peritonitis and ascites (Am J Surg Pathol 1994;18:1, Arch Pathol Lab Med 1996;120:303)
  • Leydig cell containing thecoma: if Reinke crystalloids are present in cytoplasm
Gross description
  • Unilateral (90%), well defined, firm, solid and covered by intact ovarian serosa
  • Variable size; usually yellow; often a mixture with fibroma (white)
Gross images

Images hosted on PathOut server:

Lobulated and yellow

Luteinized tumor in patient with sclerosing peritonitis

Images hosted on other servers:


Microscopic (histologic) description
  • Spindle cells with moderate pale cytoplasm containing lipid droplets and central nuclei
  • Intervening stroma has collagen deposition and focal hyaline plaque formation
  • Some tumors are heavily calcified; may have prominent stromal hyperplasia (hyperthecosis)
Microscopic (histologic) images

Images hosted on PathOut server:

Vacuolated tumor cells

Hyaline plaques

Stromal calcification

Luteinized tumor

Luteinized tumor in patient with sclerosing peritonitis

Oil Red O stain

Reticulin stain

Positive stains
  • Oil Red O or Sudan black (fat stains) on fresh / frozen tissue
  • Silver stains demonstrate reticulin fibers surrounding individual cells (note: reticulin surrounds clusters of cells in granulosa cell tumors)
Molecular / cytogenetics description
  • Trisomy 12