Hilus cell tumor of the ovary. A clinicopathological analysis of 12 Reinke crystal-positive and nine crystal-negative cases.

The clinical and pathological features of 12 Reinke crystal-positive and nine probable (crystal-negative) hilus cell tumors of the ovary were reviewed. The patients' ages ranged from 32 to 82 years. The initial manifestation was androgenic in 62% of the cases. The levels of testosterone were high (200-2,400 ng/dl) even though the tumors had a mean diameter of only 2.1 cm. All the tumors were centered in the hilus of the ovary, extending for varying distances into the ovarian stroma. They were composed of polyhedral to rounded cells with generally abundant eosinophilic cytoplasm and often showed a perivascular aggregation of nuclei with avascular pooling of cytoplasm or hyalinization of stroma. Fibrinoid changes in the vessels of the tumors were frequently noted. None of the 10 patients for whom follow-up data of 1-17 years were available died of tumor; virilizing symptoms regressed but did not completely disappear in five of the 10 patients after the removal of the tumor.