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Pure theca cell tumors. A clinicopathologic study of 29 cases.

From 1976 to 1989, 29 cases of ovarian theca cell tumors were diagnosed at the Pathology Department of our Hospital. Their clinical and histologic features were reviewed. The main presenting symptom in postmenopausal patients was uterine bleeding, whereas in premenopausal women, abdominal swelling and the findings of ultrasonographic examination were the diagnostic keys. Different surgical procedures were the cornestone of treatment, although in 12 cases the indication for surgery was not apparently related to an adnexal condition.

Adolescent↗

[Diagnosis of virilizing ovarian tumors and surgical tactics for their treatment].

The authors present the results of study of the basic blood testosterone level and of the 17-ketosteroid urinary excretion under conditions of a test with dexamethasone and choriongonin. The results obtained were compared with the results of analogous examination of a group of patients with the virile form of the Stein-Loewenthal's syndrome. Blood testosterone level served as a significant criterion in the diagnosis of virilizing tumours of the testes. Besides, a study was made of the remote results of sparing surgical tactics in the treatment of virilizing tumours of the testes lasting up to 13 years in 37 patients. Favourable results pointed to the benign course of these tumours and justified conservative therapy.

17-Hydroxycorticosteroids↗

[Luteoma of the ovary during pregnancy (author's transl)].

The tumor of lutein cells of the ovary during pregnancy was first described by Sternberg (1963) as "luteoma of pregnancy". Up to 1973/74 66 cases were published. This benign tumor occurring only during pregnancy probably arises under stimulation of chorionic gonadotropin and may cause a virilization of the mother and female infant. After birth the ovarian tumors regress spontaneouly. Lutein cell tumors are usally discovered incidentally at laparotomy (cesarean section) in late pregnancy and require no radical surgical treatment. The feature of these tumors and some related questions are discussed on the basis of on own observation being, to our knowledge, the first case of this type in Central Europe.

Chorionic Gonadotropin↗

Origin of estrogen in isosexual precocious pseudopuberty due to a granulosa-theca cell tumor.

The purpose of the present study was to quantify the rates of production and to define the mechanism(s) or origin of sex steroid hormones in a 3 1/2-year-old girl with isosexual precocious pseudopuberty caused by a granulosa-theca cell tumor of the ovary. The results suggest that the hyperestrogenism occurs principally due to the secretion of estradiol-17beta synthesized de novo by the tumor, but that the tumor in vivo was also capable of aromatizing C19 plasma precursor hormones to estrogen.

Child, Preschool↗

[Stromal thecomatosis of the ovaries associated with the syndrome of mixed ovarian dysgenesis].

On the basis of analysis of a case of a combination of mixed dysgenesia of the ovaries with stromal thecomatosis and the clinical picture of the virile syndrome a conclusion was drawn that a) hypertestosteronemia was in such cases connected with the presence in the dysgenetic ovary and the connective tissue band of epitheliod cells forming the foci of stromal thecomatosis, and b) that the appearance of stromal thecomatosis failed to depend on the presence of the follicular apparatus; apparently cells of the interstitial tissue of the cortical layer of the ovaries serve as its source.

Adolescent↗

[Conservative operations in malignant I-stage ovarian tumors].

The remote results of conservative operations in 16 patients with malignant ovarian tumors stage I are reported and compared with the results of treatment following radical (38) and nonradical (45) operations. Two thirds of conservatively operated patients (unilateral adnexectomy) survived for more than 5 years, over 50% of patients showed a 10-year survival. It is emphasized that saving operative procedures should not be performed in the presence of the factors aggravating the prognosis (proliferation of the tumor capsule, adhesions, a ruptured tumor capsule).

Adnexa Uteri↗

Further observations on spontaneous neoplasms in the Mongolian gerbil, Meriones unguiculatus.

One hundred sixty Mongolian gerbils, Meriones unguiculatus, were examined for the presence of naturally occurring lesions. The first recognized cases of cecal adenocarcinoma, testicular teratoma, and sebaceous gland pad carcinoma were found. Neoplasms previously reported from the gerbil and also seen in the present study included ovarian theca lutein and granulosa lutein cell tumors, sebaceous gland pad adenoma, cutaneous squamous cell carcinoma, malignant melanoma, and renal and splenic hemangiomas. Calcinosis cutis was also observed in two male gerbils.

Adenocarcinoma, Mucinous↗

Luteoma of pregnancy.

We have presented a case of luteoma of pregnancy, an uncommon ovarian lesion that is usually detected incidentally during cesarean section or postpartum tubal ligation. It is felt to be nonneoplastic, is hormonally stimulated, and regresses after childbirth. It is important to distinguish it from neoplastic lesions of the ovary that can occur in the same population, particularly steroid cell tumors, although this can be a difficult differential diagnosis.

Diagnosis, Differential↗

Immunohistochemical analysis for desmin in normal and neoplastic ovarian stromal tissue.

Ovarian stroma contains cells with the ultrastructural features of smooth-muscle cells. The purpose of this study was to analyze normal ovaries, ovarian stromal tumors (fibroma/thecomata and granulosa cell tumors), and ovarian leiomyomata for desmin reactivity. Groups of ovarian stromal cells that expressed desmin were noted in six of six normal ovaries. Desmin was also detected in two of six fibroma/thecomata and two of two ovarian leiomyomata. The number of tumor cells with detectable desmin was much greater in the leiomyomata. Desmin was not detected in any of six granulosa cell tumors. We conclude that stromal cells with an immunohistochemical feature of smooth-muscle cells are routinely found in normal ovaries. This study demonstrates the usefulness of immunohistochemistry in corroborating the diagnosis of ovarian leiomyomata, although desmin positivity per se is not diagnostic of ovarian leiomyomata, and also raises the possibility that some ovarian leiomyomata may be derived from stromal cells.

Adult↗

Intra-abdominal hemorrhage associated with a granulosa-thecal cell neoplasm in a mare.

A 9-year-old American Saddlebred mare was referred because of abdominal distention and signs of abdominal pain. Copious peritoneal fluid obtained by abdominocentesis appeared to be frank blood. Rectal and ultrasonographic evaluation of the abdomen revealed a large mass at the distal tip of the right uterine horn. The mare was euthanatized and necropsied and the mass was determined to be a granulosa-thecal cell neoplasm. The most common clinical sign of granulosa-thecal cell neoplasm is infertility or abnormal sexual behavior. Hemoperitoneum is infrequently associated with neoplasms in horses.

Acute Disease↗

[Lipid-cellular (lipoid-cellular) tumors of the ovaries].

In accordance with in International Histological Classification of the ovaries lipidocellular (lipoidocellular) tumours are referred to a separate group. Analysis of literature data and the author's observations demonstrated that neoplasms differing by histogenesis of newgrowth formation were placed in this group. Evidence in favour of revision of this point of the classification is presented, and suitable recommendations are given.

Adolescent↗