Ovarian Serous Cystadenofibroma With Stromal Sex Cord Elements

Abstract

This report describes an ovarian serous cystadenofibroma, in a postmenopausal woman, which exhibited extensive sex cord differentiation, in the form of solid and hollow tubules resembling Sertoli cell elements, within the stroma. The sex cord elements, which were located just beneath the epithelium, were positive with both alpha inhibin and calretinin and negative with epithelial membrane antigen. They were also CD56 positive but negative with other neuroendocrine markers. True sex cord structures or sex cord-like elements have been described in ovarian adenosarcomas and pure stromal tumors, especially fibromas. However, as far as we are aware, these elements have not been reported in a serous cystadenofibroma. The endometrium exhibited simple hyperplasia, perhaps secondary to estrogenic activity of the sex cord elements. We discuss the significance of CD56 positivity of the sex cord elements.

Unusual Ovarian Tumors With Endometrioid Proliferations Co-Expressing Estrogen Receptor and CDX-2 Arising in Cystadenofibromatous Background: Report of 3 Cases

“…Although we are not aware of any documented cases of glandular proliferations co-expressing CDX-2 and ER by immunohistochemistry arising in cystadenofibromatous background as we describe here, there are scattered case reports of other unusual proliferations in this setting. Dillon and colleagues reported a unique serous cystadenofibroma with stromal sex cord elements (7). As in our cases, the surface epithelium showed no borderline or malignant features.…”

Primary Ovarian Mucinous Cystic Tumor With Prominent Theca Cell Proliferation and Focal Granulosa Cell Tumor in its Stroma: Case Report, Literature Review, and Comparison With Sertoli-Leydig Cell Tumor With Heterologous Elements

“…That case may be similar to our case although a granulosa, as opposed to cellular theca component, is not convincingly documented. Another case has been reported of stromal sex cord elements resembling Sertoli tubules arising in the stroma of an ovarian serous cystadenofibroma (18). To our knowledge, composite granulosa cell tumor with other surface epithelial tumors has not been reported.…”

Ovarian fibrothecoma with minor sex cord elements: a case report

“…Dillon et al, reported in serous cyst adenofibroma with stromal sex cord elements whereas Ueda et al, reported in mucinous epithelial ovarian tumour with stromal sex cord elements. 16,17 Most of the tumours reported in literature are unilateral tumours except in one literature bilateral ovarian fibroma with minor sex cord elements are reported (Gupta et al). 18 Few cases in extraovarian site also reported as fibroma with minor sex cord elements in broad ligament (Omori et al).…”