Giant nodular ovaries with aberrant follicles

Two cases of an unusual variant of the Stein-Leventhal syndrome and ovary are described and two similar reported cases reviewed. Clinically three of the patients had a delayed menarche followed by irregular periods and one had irregular menorrhagia. Pathologically all four had large firm nodular ovaries of 6-9 cm in diameter, showing a gross excess of stroma and distorted or fragmented atretic follicles with unusual granulosal cell persistence. Both grossly and microscopically, ovaries of this type are liable to be mistaken for tumours, but there is no good evidence that they are either neoplastic or pre-neoplastic.