Ovarian thecoma with androgenic manifestations in a postmenopausal woman

Siekierska-Hellmann, Małgorzata; Sworczak, Krzysztof; Babińska, Anna; Wojtylak, Szymon

doi:10.1080/09513590600842539

Cited by 20 publications

(14 citation statements)

References 14 publications

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“…Rarely, fi brothecomas present with endocrine manifestations related to hormonally active tumors. In these cases, estrogenic or even some rare androgenic manifestations are reported [6]. Even though the defi nitive diagnosis of fi brothecoma is histologic, Conte et al [7] have described the presence of characteristic sonographic patterns of fi brothecoma.…”

Section: Discussionmentioning

confidence: 99%

A case of malignant fibrothecoma of the ovary

Kim

Park

2012

Korean J Obstet Gynecol

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Fibrothecomas are mesenchymal tumors deriving from the ovarian stromal and consisting of theca-like elements and fi brous tissue. They are common, but their malignant counterpart is extraordinarily rare. Classical malignant fi brothecomas are said to show four or more mitotic fi gures per 10 high power fi elds. We have experienced a rare case of malignant ovarian fi brothecoma in a 72-year-old postmenopausal woman. We report a case with brief review of literature.Keywords: Thecoma; Fibroma; Malignant neoplasms; Ovary; Mitotic Index Received: 2011.10.8. Revised: 2011.12.20. Accepted: 2012 Th is is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2012. Korean Society of Obstetrics and GynecologyFibrothecomas are benign neoplasms which belong to the estrogenic group of sex cord tumors with differentiation in fi broblastic or theca cells. Fibroma is purely composed of mature fi broblastic cells producing abundant collagen and thecoma contains many cells resembling theca cells and/or lutein cells as well as a number of fibroblastic cells. However, in some instances, differentiation between fi broma and thecoma is often diffi cult, justifying use of the term 'fi brothecoma'. Malignant ovarian fi brothecoma is a rare entity. Classical malignant fi brothecomas are said to show four or more mitotic fi gures per 10 high power fi elds (HPF). These tumors occur generally in older menopausal patient. Histologically, these tumors have a stromal origin and are composed of variable proportion of spindle cells forming collagen and theca cells containing lipids. They may be hormonally active and thus responsible for estrogenic manifestations. We report a rare case of malignant ovarian fibrothecoma in a 72-year-old postmenopausal woman. Case ReportA 72-year-old gravida 3 para 2 postmenopausal woman with no signifi cant medical history presented to our gynecology outpatient clinic with constipation and abdominal distention. No associated fever, vomiting, or localized abdominal pain occurred. The pelvic examination revealed a palpable non-tender pelvic mass. Transvaginal ultrasonogram shows a 11.3 ×11.7 ×10.2 cm sized well defi ned heterogenous echoic solid mass with some tiny cystic changes abutting on atrophic uterus in right adnexa (Fig. 1). The result of laboratory studies, including analysis of tumor markers, such as CA-125, CA19-9, squamous cell carcinoma related antigen were all within normal limits. At laparotomy, there was no ascites and a lobulated bulging mass measuring 15 cm was observed on the right ovary. The left ovary, uterus, omentum, and pelvic lymph node were unremarkable. A frozen section of the ovarian mass revealed a sex-cord stromal tumor with nuclear atypia and mitosis. The patient underwent abdominal total hystrectomy, bilateral salpingo-oophorectomy,...

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Section: Discussionmentioning

confidence: 99%

A case of malignant fibrothecoma of the ovary

Kim

Park

2012

Korean J Obstet Gynecol

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“…[8] During the reproductive age the typical picture of androgen secretion is oligomenorrhea, defeminization, and progressive masculinization (hirsutism, temporal balding, enlargement of the clitoris, deepening of the voice, and muscular development). [9] In the case of a 24-year-old woman described by Takeuchi and colleagues,[10] masculinization developed over a few months. Symptoms of defeminization and masculinization may appear simultaneously, but signs of defeminization usually appear before those of masculinization.…”

Section: Discussionmentioning

confidence: 99%

Ovarian granulosa cell tumor: An uncommon presentation with primary amenorrhea and virilization in a pubertal girl

Kota

Gayatri

Pani

et al. 2012

Indian J Endocr Metab

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A 16-year-old girl presented with primary amenorrhea and excess hair growth on her body and face for the last three years, along with pain and a mass in her lower abdomen for last one year. Examination revealed hirsutism and other virilizing features, with an irregular mass in the lower abdomen corresponding to 16 weeks’gestation. Serum testosterone was 320 ng / dl and ultrasonogram of the pelvis revealed a solid mass of 5 × 4 cm in the left adnexa. Suspecting it to be a virilizing tumor of the left ovary, the patient was subjected to staging laparotomy, which revealed stage 1a ovarian involvement amenable to surgical resection alone. Histopathological examination confirmed the diagnosis of granulosa cell tumor of the ovary. Postoperatively the serum testosterone returned to 40 ng / dl and her menstrual cycle started after two months of surgery.

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“…Review of the indexed literature (MEDLINE 1966–2008, English language; search terms: luteinized thecoma, Postmenopausal) revealed only a handful of cases of luteinized thecoma in a postmenopausal patient who had presented with virilization and alopecia [1]. There were few other reported cases of ovarian thecoma in postmenopausal woman, where the presenting symptoms were androgenic manifestations, bleeding, and abdominal pain [2, 3]. The histology of these patients did not reveal luteinization.…”

Section: Discussionmentioning

confidence: 99%

Luteinized Ovarian Thecoma in a Postmenopausal Women Presenting with Virilization

Kaluarachchi

Marasinghe²,

Batcha³

et al. 2009

Obstetrics and Gynecology International

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We report a case of luteinizing thecoma in a 58-year-old postmenopausal woman who presented with progressive androgenic features and hypertension of one year duration. She did not notice a significant change in her body weight or appetite. Her total serum testosterone level was 4.5 ng/mL. Ultrasound scan revealed a normal-sized uterus and a right-sided solid ovarian mass of 5 cm × 5 cm. Left ovary was normal. She had a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and an omentectomy performed. Histological examination confirmed the diagnosis of luteinized thecoma. This case illustrates the necessity to consider the rare possibility of luteinized ovarian thecoma as a cause for virilization in a menopausal woman.

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Ovarian thecoma with androgenic manifestations in a postmenopausal woman

Cited by 20 publications

References 14 publications

A case of malignant fibrothecoma of the ovary

A case of malignant fibrothecoma of the ovary

Ovarian granulosa cell tumor: An uncommon presentation with primary amenorrhea and virilization in a pubertal girl

Luteinized Ovarian Thecoma in a Postmenopausal Women Presenting with Virilization

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