A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

Kucur, Suna Kabil; Acar, Canan Yüksel; Temizkan, Osman; Ozagari, Aysim; Gözükara, İlay; Akyol, Atıf

doi:10.4322/acr.2016.029

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…It is well known that mucinous cystadenomas may grow rapidly during pregnancy by an unknown mechanism. Some theories suggest that these tumors may be positive for estrogen, progesterone, and human chorionic gonadotropin (HCG) receptors; however, there have been cases of receptor-negative tumors that expand rapidly during pregnancy as well [2].…”

Section: Discussionmentioning

confidence: 99%

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Benign Ovarian Tumors in Pregnancy: A Case Report of Metachronous Ipsilateral Recurrent Mucinous Cystadenoma in Initial Pregnancy and Mature Cystic Teratoma in Subsequent Pregnancy

Schreck

Mikdachi

2019

Cureus

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Mucinous cystadenomas of the ovary are benign epithelial neoplasms that can grow rapidly during pregnancy. They may cause ovarian torsion, virilization, inferior vena cava syndrome, and even preterm labor and fetal growth restriction. Various theories exist regarding the pathogenesis of these tumors. One hypothesis suggests that they may arise from teratomas. Our case report describes synchronous mucinous cystadenomas and ovarian teratomas, as well as metachronous mucinous cystadenomas in patients with a history of ovarian teratoma. There has been no report of metachronous ipsilateral teratoma after previous mucinous cystadenoma. We present a 22-year-old female with a history of bilateral ovarian tumors in a prior pregnancy noted to have a recurrent ovarian mass on her left ovary at the time of cesarean section of a subsequent pregnancy. She had two prior cystectomies for metachronous mucinous cystadenomas of her left ovary, and a right salpingo-oophorectomy for the ovarian torsion in her previous pregnancy. On her current pregnancy, she developed a mature cystic teratoma of the remaining left ovary. The rapid growth and recurrence rate of these tumors highlights the importance of close surveillance of ovarian masses during pregnancy, even those that seem benign. In this case, a history of unilateral salpingo-oophorectomy with multiple contralateral cystectomies did not appear to affect her fertility. Her future ovarian reserve is unknown, pointing to the need for adequate pre-operative counseling in similar cases of ovarian masses in pregnancy.

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Section: Discussionmentioning

confidence: 99%

“…The most common benign ovarian neoplasms are serous or mucinous cystadenomas and mature cystic teratomas. In pregnancy, mucinous cystadenomas may grow so large that they result in persistent supine hypotensive syndrome [2]. Case reports have described these tumors reaching up to 30 to 40 centimeters in diameter during pregnancy [2-3].…”

Section: Introductionmentioning

confidence: 99%

Benign Ovarian Tumors in Pregnancy: A Case Report of Metachronous Ipsilateral Recurrent Mucinous Cystadenoma in Initial Pregnancy and Mature Cystic Teratoma in Subsequent Pregnancy

Schreck

Mikdachi

2019

Cureus

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“…It is more prevalent from the third to fifth decades of life, being exceptional before puberty and after menopause. Very few cases of postmenopausal women with an androgen-producing mucinous cystadenoma had been reported, most of them in pregnant women [ 2 – 5 ]. Anecdotically, this tumour is diagnosed in adolescents [ 6 ], and to the best of our knowledge, only two cases have been reported in postmenopausal women [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our case, FSH was normal for postmenopausal range, LH was mildly suppressed according to androgen levels and β -HCG was normal. Lastly, another hypothesis is the presence of a mechanical effect, so that, the amount of hormone production would be due to a direct contact between neoplastic epithelial and stromal cells surfaces [ 2 – 5 ].…”

Section: Discussionmentioning

confidence: 99%

Virilization of a postmenopausal woman by a mucinous cystoadenoma

Díaz

Piñero

Nattero‐Chávez

et al. 2018

Oxford Medical Case Reports

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ObjectiveTo describe the case of the most hyperandrogenaemic ovarian mucinous cystadenoma reported to date.MethodsWe present the clinical, laboratory and radiologic findings in a patient with an unusual diagnosis according to age and the clinical behaviour of the tumour, as well as a review of relevant literature.ResultsA 77-year-old women came to our consult because of fronto-parietal alopecia and an augmentation of the abdominal perimeter since 1 year ago. Clitoromegaly was observed during the physical examination. Hormonal analysis showed elevated testosterone and dehydroepiandrostenerone-sulphate levels (659 ng/dL and 1950 ng/ml, respectively), and imaging examination described an andexal cystic mass dependent on the right ovary. Pathological diagnosis was “mucinous cystoadenoma”. After surgery, clinical and analytical alterations were normalized.ConclusionAlthough ovarian mucinous cystadenomas are classically classified as “nonfunctional” tumours, they exceptionally can act as functional, and produce testosterone levels as high as directly secreting hormones or germ cell tumours.

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“…7,8 Ovarian Tumours with Functioning Stroma Some benign or malignant (primary & metastatic) ovarian tumours are hormonally active as they secrete steroid hormones by stromal cells either within or adjacent to tumours. The most common primary ovarian tumour that produce androgens are benign cystic teratoma, 13 Serous 14 & mucinous cystadenomas, 15 Brenner tumour, 16 leiomyoma 17,18 and metastatic tumours that secrete androgens are Krukenberg tumour. 19 Scully RE in his study of 24 cases in ovarian tumours with functioning ovarian stroma classifies these cells into 3 types.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Incidence of Virilisation in Sex Cord Stromal Tumours of Ovary, a 5- Year Experience in a Tertiary Care Gynaecological Centre

Revathy¹,

Kanchana²

2018

jemds

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BACKGROUND Androgen secreting ovarian tumours represents less than 5% of all ovarian neoplasms. Hyperandrogenism results in development of acne, hirsutism, androgenic alopecia, menstrual irregularities & virilisation or masculinization. The objective of this study is to look for incidence of virilisation in sex cord stromal tumours and discussion regarding various causes of hyperandrogenism. MATERIALS AND METHODS A retrospective descriptive study of virilising tumours of ovary was conducted in a tertiary care gynaecological centre at Institute of obstetrics and Gynaecology, Chennai for a period of 5 years from February 2012 to February 2017. 4 cases of sex cord stromal tumours presented with signs of virilisation. RESULTS A total of 592 ovarian malignancies were identified over a period of 5 yrs. out of which 36 cases were diagnosed as sex cord stromal tumours (6.08%). The most common age group affected are between 41 to 50 yrs. with median age of 45 yrs. Right sided ovary (58%) is more commonly involved than left sided (42%) ovary. Most of the tumours were solid in appearance with average size ranging between 6 cm-10 cm. The most common symptom is abdominal mass (64%) with 4 cases presented with history of virilisation (11%). CONCLUSION Based on present study it may be concluded that patients with symptoms of virilisation require detailed clinical history, physical examination for signs, laboratory investigations & imaging to exclude causes other than ovarian neoplasm.

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A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

Cited by 7 publications

References 12 publications

Benign Ovarian Tumors in Pregnancy: A Case Report of Metachronous Ipsilateral Recurrent Mucinous Cystadenoma in Initial Pregnancy and Mature Cystic Teratoma in Subsequent Pregnancy

Benign Ovarian Tumors in Pregnancy: A Case Report of Metachronous Ipsilateral Recurrent Mucinous Cystadenoma in Initial Pregnancy and Mature Cystic Teratoma in Subsequent Pregnancy

Virilization of a postmenopausal woman by a mucinous cystoadenoma

Incidence of Virilisation in Sex Cord Stromal Tumours of Ovary, a 5- Year Experience in a Tertiary Care Gynaecological Centre

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