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Molecular and Clinical Oncology Jun 2016Previous clinical reports of benign ovarian thecoma, associated with hydrothorax, are rare. The present study presents the case of a 58-year-old women exhibiting right...
Previous clinical reports of benign ovarian thecoma, associated with hydrothorax, are rare. The present study presents the case of a 58-year-old women exhibiting right massive pleural effusions and elevated cancer antigen (CA)125, and a pelvic ultrasound revealed a hypoechoic mass. An exploratory laparotomy was subsequently performed. During the surgery, the left ovary measured 20×15×15 cm and had a smooth surface with no excrescences or papillary projections. The patient underwent right salpingo-oophorectomy. Pathological diagnosis was determined as benign ovarian thecoma. The chest radiograph revealed no pleural effusion 6 days following the surgery. The present case demonstrated a benign ovarian thecoma, associated with massive hydrothorax and elevated CA125, which mimicked an ovarian malignancy.
PubMed: 27284435
DOI: 10.3892/mco.2016.853 -
Post Reproductive Health Sep 2021We describe a 67-year-old woman with postmenopausal bleeding having ceased estrogen plus progestogen therapy nine months before. Transvaginal ultrasonography showed...
We describe a 67-year-old woman with postmenopausal bleeding having ceased estrogen plus progestogen therapy nine months before. Transvaginal ultrasonography showed endometrial thickening with normal ovarian appearance. Hormonal studies revealed high estradiol and inhibin B levels but normal androgens and adrenal hormones. Magnetic resonance image demonstrated a 13-mm left ovarian tumour. Hysterectomy and bilateral salpingo-oophorectomy were performed, and the pathological study revealed an 8 mm ovarian thecoma. This case illustrates a very unusual cause of postmenopausal bleeding. We suggest a study protocol and discuss the differential diagnosis of this case.
Topics: Aged; Estrogens; Female; Humans; Menopause; Ovarian Neoplasms; Postmenopause; Thecoma
PubMed: 34037464
DOI: 10.1177/20533691211016698 -
The American Journal of Surgical... Jul 2023Sclerosis is well-known in sclerosing stromal tumors (SSTs), as its name indicates, but has not been evaluated in other ovarian sex cord-stromal tumors (SCSTs). Its...
Sclerosis is well-known in sclerosing stromal tumors (SSTs), as its name indicates, but has not been evaluated in other ovarian sex cord-stromal tumors (SCSTs). Its presence in other SCSTs has sporadically caused diagnostic problems in cases we have seen, and this prompted us to review SCSTs with appreciable sclerosis; tumors containing at least 20% sclerosis were included. Seventy cases were identified: 20 thecomas, 20 juvenile granulosa cell tumors (JGCTs), 8 adult granulosa cell tumors (AGCTs), 5 sex cord tumors with annular tubules, 6 retiform Sertoli-Leydig cell tumors (SLCTs; all of the intermediate differentiation), 4 nonretiform SLCTs (3 well-differentiated, 1 of intermediate differentiation with heterologous elements), 4 Sertoli cell tumors, and 3 microcystic stromal tumors (MSTs). Paucicellular sclerotic zones comprised 20% to 95% of the tumors and when conspicuous often obscured diagnostic features. Thirty-one tumors (10 thecomas, 19 JGCTs, 1 AGCT, and 1 MST) showed sclerotic zones focally enveloping nodules of tumor cells, imparting a pseudolobular appearance, and sclerosis often occurred within lobules as well. Ten of these (5 thecomas and 5 JGCTs) also had prominent staghorn blood vessels, generating a low-power appearance focally similar to SST. In 17 tumors, the sclerosis resulted in "compression" of the tumor cells into cords and/or solid tubules. Correct diagnosis in these cases is dependent on careful examination of the cellular zones of the neoplasms, but awareness of the extent of sclerosis that may be seen in diverse SCSTs may be crucial in suggesting the correct diagnosis particularly when the material is limited as in the intraoperative setting. Our findings highlight for the first time the occurrence and character of sclerosis in sex cord tumors other than SSTs and fibromas. Sclerosis is seen in descending proportion of the tumor types as follows: retiform SLCTs, thecomas, MSTs, JGCTs, sex cord tumors with annular tubules, Sertoli cell tumors, AGCTs, and nonretiform SLCTs. Its character can vary somewhat, having particular features in the sex cord tumor with annular tubules (hyaline material within tubules often coalescing and extending beyond the nests to form confluent aggregates) and retiform SLCTs (common in papillary cores).
Topics: Adult; Female; Humans; Male; Biomarkers, Tumor; Granulosa Cell Tumor; Immunohistochemistry; Ovarian Neoplasms; Sclerosis; Sertoli Cell Tumor; Sex Cord-Gonadal Stromal Tumors; Testicular Neoplasms; Thecoma; Case Reports as Topic
PubMed: 37184091
DOI: 10.1097/PAS.0000000000002049 -
Asian Journal of Surgery Mar 2024
Topics: Female; Humans; Thecoma; Ovarian Neoplasms; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Granulosa Cell Tumor
PubMed: 38114398
DOI: 10.1016/j.asjsur.2023.12.017 -
Chirurgia (Bucharest, Romania : 1990) Aug 2021Meigs syndrome consists of the presence of a benign ovarian tumor, ascites and pleural effusion, and the latter two subdued after surgical excision of the ovarian...
Meigs syndrome consists of the presence of a benign ovarian tumor, ascites and pleural effusion, and the latter two subdued after surgical excision of the ovarian tumor. Elevated Ca-125 in this context is confusing and is reported only in a handful of cases. A rare but striking case with the above features is presented herein. Case Presentation: A 46-year-old woman with a giant pelvic/abdominal mass originating from her right adnexa, ascites and pleural effusion, with elevated Ca-125 (938 IU/mL) was treated with the presumptive diagnosis of stage IV ovarian cancer. Imaging modalities showed a 22 cm solid adnexal mass and the patient underwent total abdominal hysterectomy and bilateral salpigooophorectomy, omentectomy and drainage of 4L of ascetic fluid. Surprisingly, final histopathology was negative for malignancy, characterizing the primary tumor as ovarian thecoma. Ascites and pleural effusion resolved by the seventh postoperative day, setting the diagnosis of Meigs syndrome. Meigs syndrome accounts for 1% of all ovarian tumors, however it should be considered in the differential diagnosis when clinicians come across the classic triad of the syndrome, even when Ca-125 is elevated. These patients have normal life expectancy with meticulous management, while pathophysiology of this condition remains uncertain in various points.
Topics: Ascites; CA-125 Antigen; Female; Humans; Meigs Syndrome; Middle Aged; Ovarian Neoplasms; Thecoma; Treatment Outcome
PubMed: 34463241
DOI: 10.21614/chirurgia.116.eC.1912 -
Medicine May 2020To investigate the magnetic resonance imaging (MRI) findings in ovarian thecoma and improve preoperative diagnostic accuracy.Retrospective analysis was performed on 45... (Observational Study)
Observational Study
To investigate the magnetic resonance imaging (MRI) findings in ovarian thecoma and improve preoperative diagnostic accuracy.Retrospective analysis was performed on 45 patients with surgically and pathologically confirmed ovarian thecoma. Patients were grouped into those with maximum lesion diameter ≥5 cm and <5 cm. Diagnostic scores (up to 6 points) were evaluated on the basis of MRI performance.The ≥5 cm group contained 36 cases (cystic necrosis, 32 cases) with the following findings: T1WI: isointense signal, 22 cases; slightly hypointense signal, 14 cases; T2WI: isointense signal, 6 cases; slightly hypointense signal, 21 cases; slightly hyperintense signal, 9 cases; Diffusion-weighted imaging (DWI): hyperintense signal, 23 cases; mixed hyperintense signal, 13 cases; slight enhancement on dynamic enhanced scans; pelvic fluid accumulation, 31 cases. The diagnostic score evaluations yielded 6 points in 31 cases, 5 points in 1 case, 4 points in 2 cases, and 3 points in 2 cases. The <5 cm group contained 9 cases (cystic necrosis, 3 cases) with the following findings: T1WI: isointense signal, 3 cases; slightly hypointense signal, 6 cases; T2WI: isointense signal, 2 cases; slightly hypointense signal, 4 cases; slightly hyperintense signal, 3 cases; DWI, hyperintense signal; slight enhancement in 8 cases and significant enhancement in 1 case; pelvic fluid accumulation, 4 cases. The diagnostic score evaluations yielded 6 points in 3 cases, 5 points in 1 case, 4 points in 4 cases, and 3 points in 1 case. (iii) Incidence of pelvic fluid accumulation and cystic necrosis differed depending on the size of the lesion (P = .007, .000).Larger lesions show hyperintense or mixed hyperintense signals on DWI along with pelvic fluid and cystic necrosis; whereas, smaller lesions show a hyperintense signal on DWI, cystic necrosis is rare. MRI characteristics along with the patient age and laboratory findings can improve the accuracy of preoperative diagnosis of these lesions.
Topics: Adult; Aged; China; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Ovarian Neoplasms; Radiology; Sensitivity and Specificity; Thecoma
PubMed: 32481327
DOI: 10.1097/MD.0000000000020358 -
American Journal of Obstetrics and... Mar 2017
Topics: Female; Humans; Middle Aged; Ovarian Neoplasms; Thecoma
PubMed: 27697427
DOI: 10.1016/j.ajog.2016.09.100 -
Academic Radiology Oct 2020To investigate the value of MRI-based features and texture analysis (TA) in the differential diagnosis between ovarian thecomas/fibrothecomas (OTCA/f-TCAs) and uterine...
Diagnostic Performance of MR Imaging-based Features and Texture Analysis in the Differential Diagnosis of Ovarian Thecomas/Fibrothecomas and Uterine Fibroids in the Adnexal Area.
RATIONALE AND OBJECTIVES
To investigate the value of MRI-based features and texture analysis (TA) in the differential diagnosis between ovarian thecomas/fibrothecomas (OTCA/f-TCAs) and uterine fibroids in the adnexal area (UF-iaas).
MATERIALS AND METHODS
This retrospective study included 16 OTCA/f-TCA and 37 UF-iaa patients who underwent conventional MRI and DWI between August 2014 and September 2018. Three-dimensional TA was performed with T2-weighted MRI. The clinical, MRI-based and texture features were compared between OTCA/f-TCAs and UF-iaas. Multivariate logistic regression analysis was used for filtering the independent discriminative features and constructing the discriminating model. ROCs were generated to analyse MRI-based features, texture features and their combination for discriminating between the two diseases.
RESULTS
Six imaging-based features (ipsilateral ovary detection, arterial period enhancement, lesion components, peripheral cysts, "whorl signs", mean ADCs) and six texture features (Histogram-energy, Histogram-entropy, Histogram-kurtosis, GLCM-energy, GLCM-entropy, and Haralick correlation) were significantly different between OTCA/f-TCAs and UF-iaas (p < 0.05). Multivariate analysis of the MRI-based features revealed that arterial period enhancement (OR = 0.104), peripheral cysts (OR = 16.513), and whorl signs (OR = 0.029) were independent features for discriminating between OTCA/f-TCAs and UF-iaas (p < 0.05). Multivariate analysis of the texture features showed that Histogram-energy and GLCM-energy were independent features for discriminating between OTCA/f-TCAs and UF-iaas (p < 0.05). The area under the curve of imaging-based diagnosis was 0.85, and the combination of imaging-based diagnosis and TA improved the area under the curve to 0.87, with higher accuracy, specificity and sensitivity of 86%, 92%, and 84%, respectively (p < 0.05).
CONCLUSIONS
MRI-based features can be useful in differentiating OTCA/f-TCAs from UF-iaas. Furthermore, combining imaging-based diagnosis and TA can improve diagnostic performance.
Topics: Diagnosis, Differential; Female; Humans; Leiomyoma; Magnetic Resonance Imaging; Retrospective Studies; Thecoma
PubMed: 32035760
DOI: 10.1016/j.acra.2019.12.025 -
International Journal of Surgery Case... May 2022Leiomyosarcomas of the ovary are extremely rare neoplasia usually occurring in perimenopausal patients.
INTRODUCTION AND IMPORTANCE
Leiomyosarcomas of the ovary are extremely rare neoplasia usually occurring in perimenopausal patients.
CASE PRESENTATION
A 16-year-old female patient, with no particular pathological history, who presented with chronic pelvic pain. On imaging; presence of a suprauterine solid cystic formation of 12 cm long axis. Tumor markers were normal. On exploration, solid cystic formation of 15 cm long axis. A total hysterectomy with bilateral salpingo-oophorectomy associated with bilateral pelvic and para-aortic lymphadenectomy and a total omentectomy were performed. Anatomical pathology; an ovarian leiomyosarcoma.
CLINICAL DISCUSSION
Leiomyosarcomas of the ovary are extremely rare, representing less than 1% of all ovarian malignancies. They probably derive from the smooth muscle component. No definitive diagnostic criteria for ovarian leiomyosarcomas have been adopted to date, however the histological criteria adopted are those for uterine leiomyosarcomas. The differential diagnosis of these tumors includes fibrosarcomas, rhabdomyosarcomas, thecomas and extradigestive stromal tumors. The prognosis of ovarian leiomyosarcomas is generally poor. Complete surgical resection remains for all authors the cornerstone of treatment. The benefit of adjuvant therapies, namely chemotherapy or radiotherapy, remains to be proven.
CONCLUSION
Leiomyosarcoma of the ovary, although exceptional, should always be included among the diagnostic possibilities when an ovarian cyst of organic appearance is discovered in a perimenarcheal patient.
PubMed: 35468378
DOI: 10.1016/j.ijscr.2022.107094 -
La Tunisie Medicale Jan 2017Ovarian fibro-thecoma are rare presenting 1 to 4, 7%of ovarian organictumors. These tumors are of stromal origin and contain varied proportion of fusiform connective...
INTRODUCTION
Ovarian fibro-thecoma are rare presenting 1 to 4, 7%of ovarian organictumors. These tumors are of stromal origin and contain varied proportion of fusiform connective tissue cells and theca cells. They mainly affect menopausal or perimenopausal women. This tumor is benign in most cases and may be responsible for hormone secretion.
OBJECTIVES
Study the epidemiological and clinical data of patients with ovarian fibro-thecoma, analyze ultrasonographic characteristics of these tumors,and evaluate the sensitivity and specificity of pelvic ultrasound in ovarian fibro-thecoma approach.
METHODS
A retrospective study of 47 patients who underwent surgical treatment for ovarian fibro-thecoma was performed. Data were collected in our department of gynecologyand obstetrics A within Charles Nicole hospital in Tunis, over a period of 18 years between January 1994 and December 2012. For each of our observations, we analyzed the clinical and para-clinical data, including U.S. characteristics and available MRI data with confrontation to the final histological results.
RESULTS
The average age of patients was 45.2 years. The average gravidity was 4 and the mean parity was 3. . Thirty-eight of our patients were postmenopausal (80.85%). Ovarian tumor was discovered incidentally in 11 cases and on the occasion of functional symptoms in 36 cases including pelvic pain in 18 cases. Physical examination revealed a pelvic mass in 17 patients and pelvic-abdominal in 14 patients. All patients underwent a pelvic ultrasound. . Ultrasound identified 49 tumors (2 cases of bilateral tumors). Average size of tumors was 10, 05 cm (4 to 30 cm). ) . Ovarian tumor was echogenic in 9 cases (18.36%), hypoechoic in 14 cases (28.47%), mixed in 14 cases (28.47%) and anechoic in 12 cases (24.49%). The tumor was found to be solid in 27 cases (55.1%); cystic in 8 cases (16.3%) and solido cystic in 14 cases (28.6%).It was compartmentalized in 10 cases. Extra cystic vegetations were found in 2 patients. The tumor was nonvascularized at color Doppler in 47 cases (95.9%) and slightly vascularized in 2 cases (4.1%). Intra peritoneal effusion was objectified in 15 cases. The diagnosis of ovarian fibro-thecoma was raised based on U.S in 25 cases (51.02%) before surgery .MRI was performed in four cases. All patients underwent surgery. We performed laparotomy in 36 cases and laparoscopy in 11 cases. By laparotomy were performed a total hysterectomy with bilateral oophorectomy in most cases (26 patients). By laparoscopy we did lumpectomy in all cases. . The final pathologic examination revealed 19 fibromas, 14cystadénofibromas and 14 fibrothecomas.
CONCLUSION
The paraclinical exploration of ovarian fibro-thecoma isbased, as all ovarian tumors, on ultrasound examination. The most typical features are images of solid tumors with regular contours, echogenic or mixed with the presence of streakedshadows.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Fibroma; Humans; Magnetic Resonance Imaging; Middle Aged; Ovarian Neoplasms; Pelvis; Predictive Value of Tests; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Thecoma; Tunisia; Ultrasonography; Young Adult
PubMed: 29327766
DOI: No ID Found