Cellular Fibroma of the Ovary with Multiloculated Macroscopic Characteristics: Case Report

Adad, Sheila Jorge; Laterza, Valeria Lima; Santos, Carlos David Teixeira dos; Ladeia, Antônio Alexandre Lisbôa; Saldanha, João Carlos; Silva, Cléber Sérgio da; Souza, Luis Ronan Marquez Ferreira e; Murta, Eddie Fernando Cândido

doi:10.1155/2012/283948

Cited by 11 publications

(8 citation statements)

References 9 publications

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“…It usually presents as an ovarian mass, which may be accompanied by hemorrhage, edema, and cystic degeneration. Cystic degeneration usually forms a single cyst; in rare cases, it may be polycystic[ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Recurrent postmenopausal bleeding - just endometrial disease or ovarian sex cord-stromal tumor? A case report

Wang¹,

Yang²,

Wang³

2022

WJCC

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BACKGROUND Postmenopausal bleeding (PMB) is a common gynecologic complaint among elderly women, and endometrial hyperplasia is a common cause of this bleeding. Ovarian fibromas are the most common type of ovarian sex cord-stromal tumor (SCST). They arise from non-functioning stroma, rarely show estrogenic activity, and stimulate endometrial hyperplasia, causing abnormal vaginal bleeding. CASE SUMMARY We report herein the case of a 64-year-old Chinese woman who presented with recurrent PMB. A sex hormone test revealed that her estrogen level was significantly higher than normal, and other causes of hyperestrogenism had been excluded. The patient had undergone four curettage and hysteroscopy procedures in the past 7 years due to recurrent PMB and endometrial hyperplasia. The culprit behind the increase in estrogen level—an ovarian cellular fibroma with estrogenic activity—was eventually found during the fifth operation. CONCLUSION Ovarian cellular fibromas occur insidiously, and some may have endocrine functions. Postmenopausal patients with recurrent PMB and endometrial thickening observed on ultrasonography are recommended to undergo sex hormone testing while waiting for results regarding the pathology of the endometrium. If the estrogen level remains elevated, the clinician should consider the possibility of an ovarian SCST and follow-up the patient closely, even if the imaging results do not indicate ovarian tumors. Once the tumor is found, it should be removed as soon as possible no matter the size to avoid endometrial lesions due to long-term estrogen stimulation. More studies are needed to confirm whether preventive total hysterectomy with bilateral salpingo-oophorectomy should be recommended for women with recurrent PMB exhibiting elevated estrogen levels, despite the auxiliary examination results not indicating ovarian mass. The physical and psychological burden caused by repeated curettage could be prevented using this technique.

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Section: Discussionmentioning

confidence: 99%

Recurrent postmenopausal bleeding - just endometrial disease or ovarian sex cord-stromal tumor? A case report

Wang¹,

Yang²,

Wang³

2022

WJCC

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“…Symptoms may include lower abdominal pain or pressure discomfort. 3 Most of them are asymptomatic until they enlarge or involve adjacent organs and structures. 3 Upon gross pathologic inspection, ovarian fibromas are firm and white or tan.…”

Section: Discussionmentioning

confidence: 99%

“…7 CT scan: fibroma usually unilateral manifest as diffuse, slightly hypo attenuating mass with poor, very contrast enhancement. 3,6,7 MRI: signal characteristic include homogeneous, relatively low intensity. When containing scattered highsignal-intensity areas representing cystic degeneration.…”

Section: Discussionmentioning

confidence: 99%

Ovarian fibroma with elevated CA125 and OVA1 in postmenopausal woman

Keypour

Naghi

2014

Int J Reprod Contracept Obstet Gynecol

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Ovarian fibroma is a sexcord stromal tumor, which accounts for 4% of all ovarian tumors. It is uncommon benign tumor of ovary. Clinically, it is asymptomatic and may typically be detected during routine gynecological examinations. It may be associated with ascitis and hydrothorax known as Meig's Syndrome. Usually these ovarian tumors are unilateral, solid, hard masses with small areas of cystic degeneration. Due to their solid structure, these benign tumors are sometimes confused with malignant ovarian neoplasm during clinical evaluation. A 59 year old postmenopausal woman presented with flank pain and new onset urinary incontinence. Ultrasound evaluation revealed a pelvic mass. Labs showed elevated tumor marker level. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological examination however revealed an ovarian fibroma. During the postmenopausal years, the ovaries become atrophic. The incidence ovarian neoplasm increases with age. A suspicious or persistent complex mass and increased tumor marker like CA125 and OVA1 in post-menopausal woman requires surgical evaluation. The traditional diagnostic tools for ovarian tumors are bimanual examination, pelvic ultrasound and measuring serum biomarker like CA125 level, but these methods have low specificity and sensitivity. Now-a-days the role of some tumor marker such as OVA1in the management of ovarian tumor has been approved by FDA.

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“…Asymptomatic nature and poor prognosis are the fundamental factors if ignoring all other aspects. As benign disease mostly lead to malignancy, early diagnosis remains the core priority [2].…”

Section: Introductionmentioning

confidence: 99%

Human Epididymis Protein (He4) as a Novel Biomarker for Differential Diagnostic Potential for Benign Ovarian Cysts in Correlation With the Putative Ca125 in Ultrasonogarphically (Usg) Confirmed Patients

2021

IJBPAS

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Cellular Fibroma of the Ovary with Multiloculated Macroscopic Characteristics: Case Report

Cited by 11 publications

References 9 publications

Recurrent postmenopausal bleeding - just endometrial disease or ovarian sex cord-stromal tumor? A case report

Recurrent postmenopausal bleeding - just endometrial disease or ovarian sex cord-stromal tumor? A case report

Ovarian fibroma with elevated CA125 and OVA1 in postmenopausal woman

Human Epididymis Protein (He4) as a Novel Biomarker for Differential Diagnostic Potential for Benign Ovarian Cysts in Correlation With the Putative Ca125 in Ultrasonogarphically (Usg) Confirmed Patients

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