Decoding a Rare Ovarian Entity: Clinical and Pathological Insights into Sclerosing Stromal Tumor (SST)

Sclerosing stromal tumors (SSTs) are exceptionally rare, benign ovarian neoplasms that typically present in young women during their second and third decades of life. This case report explores the clinical journey of a young female patient diagnosed with an ovarian SST, emphasizing the diagnostic and therapeutic nuances of this uncommon pathology.

Clinical presentation is often nonspecific, with symptoms such as abdominal pain, bloating, or menstrual irregularities, frequently mimicking other ovarian masses and adding to the diagnostic complexity. Radiologic findings may be inconclusive, reinforcing the necessity of histopathological examination for definitive diagnosis.

Histologically, SSTs are characterized by a pseudolobular arrangement of cellular and hypocellular areas, with prominent collagen deposition and hyalinized stroma. The heterogeneity in tissue patterns makes immunohistochemistry essential for accurate identification and differentiation from other sex cord-stromal or fibrous tumors.

Surgical resection remains the primary treatment modality, with a strong emphasis on ovarian preservation, especially in young women. Intraoperative frozen section analysis assists in distinguishing SSTs from malignant lesions, thereby guiding the extent of surgical intervention. Given the tumor's benign nature, adjuvant therapy is typically unnecessary.

This case underscores the importance of a multidisciplinary approach, involving gynecologists, pathologists, and radiologists, to ensure precise diagnosis and optimal outcomes. As we continue to encounter such rare tumors, further research is needed to deepen our understanding of SST pathogenesis and refine management strategies tailored to fertility preservation.

Source: Madhuri, T. S., & Sharma, N. (2025). Case report: Sclerosing stromal tumor in a young female: Clinical presentation and management. Indian Journal of Obstetrics and Gynecology Research, 12(1), 159–163. https://doi.org/10.18231/j.ijogr.2025.029