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International Journal of Gynecological... Jan 2018Microscopic, heterotopic extraovarian sex cord-stromal proliferations have only recently been reported in the literature. We describe the largest series to date, of 30...
Microscopic, heterotopic extraovarian sex cord-stromal proliferations have only recently been reported in the literature. We describe the largest series to date, of 30 cases of microscopic, incidentally detected, heterotopic extraovarian sex cord-stromal proliferation, in women aged 25-79 yr who had undergone surgery for a range of benign and malignant gynecologic conditions. In 14 patients the foci of proliferation comprised ovarian cortical stroma, in some cases with an ovarian fibroma-like appearance. Ten cases of adenofibroma and cystadenofibroma were also identified, including 1 Brenner adenofibroma; 2 cases comprised both ovarian cortical stroma and serous cystadenofibroma; 4 cases showed sex cord proliferation resembling microscopic adult granulosa cell tumors. Immunohistochemistry, where possible, confirmed the sex cord nature of the heterotopic proliferations. The foci of proliferation were <1-7 mm, and most were at the fimbrial end of the fallopian tube. These proliferations are likely to be encountered with increasing frequency as we sample the adnexa more extensively. Previous reports postulated that the proliferations probably represent embryonic rests caused by anomalous migration but we suggest that incorporation of exposed ovarian parenchymal tissue into the fimbrial stroma at the time of ovulation may be another possible cause.
Topics: Adenofibroma; Adult; Aged; Cell Proliferation; Cystadenofibroma; Fallopian Tubes; Female; Fibroma; Granulosa Cell Tumor; Humans; Immunohistochemistry; Middle Aged; Ovarian Neoplasms; Ovary; Sex Cord-Gonadal Stromal Tumors
PubMed: 28319576
DOI: 10.1097/PGP.0000000000000382 -
Diagnostic Pathology Oct 2022Ovarian fibroma is the most common benign pure stromal tumor. It has no specific clinical manifestation, most of which are pelvic or adnexal masses. 10-15% of cases with... (Review)
Review
Ovarian fibroma is the most common benign pure stromal tumor. It has no specific clinical manifestation, most of which are pelvic or adnexal masses. 10-15% of cases with hydrothorax or ascites, after tumor resection, hydrothorax and ascites disappear, known as Meigs Syndrome. The elevated level of CA125 in a few patients was easily misdiagnosed as ovarian malignant tumor. A case of bilateral Ovarian fibroma associated with Meigs Syndrome is reported and the literature is reviewed in order to improve the understanding of the changes and avoid misdiagnosis.
Topics: Ascites; Female; Fibroma; Humans; Hydrothorax; Meigs Syndrome; Ovarian Neoplasms
PubMed: 36253781
DOI: 10.1186/s13000-022-01258-9 -
Molecular Medicine Reports Feb 2018Ovarian cancer is the most common and lethal type of gynecological malignancy, due to its invasiveness. The present study aimed to analyze the molecular mechanism...
Ovarian cancer is the most common and lethal type of gynecological malignancy, due to its invasiveness. The present study aimed to analyze the molecular mechanism underlying chemoresistance in ovarian carcinoma cells, which may lead to local migration toward adjacent tissues and long‑distance metastasis to other organs. A total of 12 patients with ovarian fibroma were used to evaluate chemoresistance and chemosensitivity. The sensitivity and resistance of ovarian carcinoma cells was measured using apoptosis analysis, morphological observation, survival rate analysis, immunohistochemistry and immunostaining. The mechanism underlying the interaction between the epithelial‑mesenchymal transition (EMT) and liver kinase B1 (LKB1)‑salt‑inducible kinase 1 (SIK1) signaling pathways was additionally investigated in ovarian carcinoma. The results of the present study demonstrated that ovarian carcinoma cells isolated from patients exhibited apoptosis resistance. Inhibition of TGF‑β expression led to an inhibition of growth, migration and invasion, in addition to a promotion of apoptosis, in ovarian carcinoma cells treated with paclitaxel. Studies have indicated that the LKB1‑SIK1 signaling pathway may be suppressed in ovarian carcinoma cells compared with normal ovarian cells, leading to activation of the EMT signaling pathway. The results of the present study demonstrated that upregulation of LKB1 promoted SIK1 expression and markedly suppressed the growth and aggressiveness of ovarian cancer cells. Upregulation of LKB1 additionally promoted apoptosis in ovarian carcinoma cells. In addition, the results of the present study demonstrated that the knockdown of LKB1 further promoted the expression of transforming growth factor‑β and EMT, which downregulated the chemosensitivity of ovarian carcinoma cells. Additionally, overexpression of LKB1 in ovarian carcinoma cells increased chemosensitivity, resulting in a significant inhibition of migration and invasion. The present findings indicated that the enhancement of LKB1‑SIK1 suppressed the growth and aggressiveness of ovarian carcinoma cells isolated from clinical patients, which subsequently contributed to an inhibition of metastatic potential. In conclusion, targeting the LKB1‑SIK1 signaling pathway to inhibit EMT may provide potential therapeutic benefits in ovarian carcinoma.
Topics: AMP-Activated Protein Kinase Kinases; Adult; Apoptosis; Epithelial-Mesenchymal Transition; Female; Fibroma; Humans; Middle Aged; Ovarian Neoplasms; Ovary; Protein Serine-Threonine Kinases; Signal Transduction; Transforming Growth Factor beta
PubMed: 29257268
DOI: 10.3892/mmr.2017.8229 -
Anticancer Research May 2017Mitotically-active cellular fibroma (MACF) is a rare form of ovarian fibromatous tumor. Although it is generally acknowledged to have indolent biological behavior, its...
Mitotically-active cellular fibroma (MACF) is a rare form of ovarian fibromatous tumor. Although it is generally acknowledged to have indolent biological behavior, its rarity and overlapping histopathological features with more common and aggressive entities make MACF prone to misdiagnosis and overtreatment. The clinicopathological characteristics of ovarian MACF have not been clearly established. Our 10-year review of cellular fibromatous tumors of the ovary diagnosed at a single institution revealed four cases of cellular fibroma (CF) and three cases of MACF. The mean age of patients with MACF was 46 years (range=20-71 years). Patients presented with symptoms related to pelvic masses, such as abdominal pain and discomfort and flank pain. Serum levels of cancer antigen 125 was increased in two patients with MACF. All cases of MACF were a single unilateral tumor. Magnetic resonance imaging revealed solid or mixed solid and cystic ovarian masses with diameters of 7.3-14.9 cm. The radiological impressions included benign stromal tumor, benign epithelial tumor, and borderline epithelial tumor. Grossly, MACFs exhibited yellow-to-tan fleshy cut surfaces, without necrosis or hemorrhage. Extensive hyaline degeneration, resulting in a fibrotic cut surface, was observed in one case. Histologically, MACF displayed frequent mitotic figures, as well as increased cellularity and mild cytological atypia. The mean mitotic count was 8.7 per 10 high-power fields. MACF is a newly-recognized subtype of ovarian cellular fibromatous tumor. Pathologists and clinicians should be aware of this rare entity to prevent misdiagnosis of MACF as fibrosarcoma or adult granulosa cell tumor and resultant overtreatment.
Topics: Adult; Aged; Diagnosis, Differential; Female; Fibroma; Humans; Magnetic Resonance Imaging; Middle Aged; Mitosis; Ovarian Neoplasms; Ovary; Young Adult
PubMed: 28476827
DOI: 10.21873/anticanres.11599 -
Taiwanese Journal of Obstetrics &... Jul 2023Ovarian fibromas are benign, sex cord-stromal tumors occurring in both peri- and post-menopausal women. Generally, these tumors are non-functional and do not produce...
OBJECTIVE
Ovarian fibromas are benign, sex cord-stromal tumors occurring in both peri- and post-menopausal women. Generally, these tumors are non-functional and do not produce hormones. However, this case report proves the first case of steroid hormone synthesis in an ovarian fibroma by immunohistochemistry.
CASE REPORT
A 77-year-old post-menopausal woman presented with a left ovarian tumor, abnormal endometrial thickness, and high levels of estradiol (E2). The tumor was found to be a fibroma, which was positive for alpha-inhibin. We examined estrogen-producing enzymes using immunohistochemistry. The tumor was positive for estrogen receptor, progesterone receptor, 17β-hydroxysteroid dehydrogenase (HSD)-1, adrenal 4 binding protein/steroidogenic factor 1, 17β-HSD-5, steroid sulfatase, and P450c17.
CONCLUSION
This case study shows that E2 can be locally produced from circulating inactive steroids, by estrogen-producing enzymes. This is the first report of steroid hormone synthesis in an ovarian fibroma.
Topics: Female; Humans; Aged; Postmenopause; Ovarian Neoplasms; Steroids; Estrogens; Estradiol; Fibroma; Steroid 17-alpha-Hydroxylase
PubMed: 37407196
DOI: 10.1016/j.tjog.2023.01.008 -
The Pan African Medical Journal 2015Ovarian fibroma is the most common benign solid tumors of the ovary, commonly misdiagnosed as uterine fibromaor as malignant ovarian tumors. It occurs generally in older...
Ovarian fibroma is the most common benign solid tumors of the ovary, commonly misdiagnosed as uterine fibromaor as malignant ovarian tumors. It occurs generally in older perimenopausal and postmenopausal women. Occasionally large fibromas may undergo torsion causing acute abdominal pain. Doppler Ultrasonographyimaging is the choice study. CT and MRI are often needed for further characterization and differentiation from other solid ovarian masses. The choice treatment is surgical removal with intraoperative frozensection. Immunohistochemicalanalysis is recommended to rule out the differential diagnosis. Here we present a case of a postmenopausal woman with a large twisted ovarian fibroma reflecting diagnostic and management difficulties including potential misdiagnosis of the tumor as a malignant ovarian neoplasm that may influence the surgical approach.
Topics: Abdominal Pain; Diagnosis, Differential; Female; Fibroma; Humans; Middle Aged; Ovarian Neoplasms; Postmenopause
PubMed: 26175813
DOI: 10.11604/pamj.2015.20.322.5998 -
Journal of Pediatric and Adolescent... Oct 2016Meigs syndrome is a rare complication associated with ovarian fibromas. Although ovarian fibromas are rare in children, they are common in women with Gorlin syndrome...
BACKGROUND
Meigs syndrome is a rare complication associated with ovarian fibromas. Although ovarian fibromas are rare in children, they are common in women with Gorlin syndrome after puberty.
CASE
A 14-year-old girl with Gorlin syndrome was admitted to our hospital for ablation of basal cell carcinoma. A chest x-ray revealed pleural effusion. Ultrasonography revealed bilateral multinodular ovarian masses. Meigs syndrome associated with ovarian fibromas was considered. A laparotomy revealed bilateral ovarian masses, which were resected. Microscopically, the masses were composed of mitotically active fibroma and areas resembling hemangiopericytoma and luteinized thecoma. The pleural effusion disappeared soon after the surgery.
SUMMARY AND CONCLUSION
Physicians should consider the possibility that pleural effusion might precede the diagnosis of ovarian fibroma in patients with Gorlin syndrome.
Topics: Adolescent; Basal Cell Nevus Syndrome; Diagnosis, Differential; Female; Fibroma; Humans; Meigs Syndrome; Ovarian Neoplasms; Pleural Effusion, Malignant
PubMed: 27079916
DOI: 10.1016/j.jpag.2016.03.010 -
International Journal of Surgical... May 2021
Topics: Cell Nucleus; Female; Fibroma; Humans; Middle Aged; Ovarian Neoplasms; Ovariectomy; Ovary
PubMed: 32390474
DOI: 10.1177/1066896920919988 -
Ultrasound Quarterly Sep 2015
Topics: Diagnosis, Differential; Female; Fibroma; Humans; Meigs Syndrome; Middle Aged; Ovarian Neoplasms; Ovary; Ultrasonography
PubMed: 25715273
DOI: 10.1097/RUQ.0000000000000144 -
Journal of Histotechnology Dec 2020A postmenopausal woman with lobular breast carcinoma metastatic to a large ovarian fibrothecoma is presented. The two metastatic tumor nodules were grossly subtle and...
A postmenopausal woman with lobular breast carcinoma metastatic to a large ovarian fibrothecoma is presented. The two metastatic tumor nodules were grossly subtle and could have been overlooked in the background of the large ovarian stromal tumor. Thorough sampling of the tumor for histologic examination and supporting immunohistochemical stains were important in establishing the diagnosis. Differential diagnostic considerations are discussed.
Topics: Aged; Biomarkers, Tumor; Carcinoma, Lobular; Diagnosis, Differential; Female; Fibroma; Humans; Neoplasms, Second Primary; Ovarian Neoplasms; Sex Cord-Gonadal Stromal Tumors; Thecoma; Triple Negative Breast Neoplasms
PubMed: 32508260
DOI: 10.1080/01478885.2020.1773638