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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 -
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 -
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 -
Cancer Genetics and Cytogenetics Oct 2007Traditional cytogenetic studies of ovarian stromal tumors are few, although trisomy 12 has been frequently documented with fluorescence in situ hybridization (FISH). In...
Traditional cytogenetic studies of ovarian stromal tumors are few, although trisomy 12 has been frequently documented with fluorescence in situ hybridization (FISH). In the current study, karyotypic analysis of four ovarian stromal tumors and a review of the literature suggest that numerical abnormalities of chromosomes 4 and 9 might also be important, possibly as secondary changes. To determine the frequency of 4, 9, and 12 aneuploidy in a larger group of ovarian tumors, FISH studies were performed on eight fibromas, three thecomas, one fibrothecoma, and five cellular fibromas. Trisomy 12 was identified in all five cellular fibromas as well as in two fibromas and the fibrothecoma. Gain of chromosome 9 was confined to the cellular fibromas. Loss of chromosomes 4 and/or 9 was prominent in the fibromas. These findings confirm the presence of trisomy 12 as a nonrandom chromosomal abnormality in ovarian stromal tumors. Moreover, these conventional and molecular cytogenetic data indicate that gain of chromosome 9 in addition to gain of chromosome 12 is prominent in cellular fibroma. In contrast, loss of chromosomes 4 and/or 9 are recurrent in fibroma. In summary, imbalances of chromosomes 4 and 9 appear to represent important secondary abnormalities in the thecoma-fibroma ovarian tumor group.
Topics: Adult; Aged; Aged, 80 and over; Allelic Imbalance; Chromosome Mapping; Chromosomes, Human, Pair 12; Chromosomes, Human, Pair 4; Chromosomes, Human, Pair 9; Female; Fibroma; Humans; Karyotyping; Middle Aged; Ovarian Neoplasms; Recurrence; Thecoma
PubMed: 17954269
DOI: 10.1016/j.cancergencyto.2007.07.009 -
Revista de La Facultad de Ciencias... Jun 2021During menopausal transition, mild clinical signs of hyperandrogenism may appear as part of the normal aging process, but the development of frank virilization suggests...
During menopausal transition, mild clinical signs of hyperandrogenism may appear as part of the normal aging process, but the development of frank virilization suggests a specific source of androgen excess. In this context, androgen-secreting tumors at both adrenal and ovarian levels should be ruled out. We present the case of a 51-year-old postmenopausal woman with signs of 12 month period virilization, associated with personal history of type 2 diabetes and arterial hypertension, poorly managed in the past year. Laboratory tests showed elevation of serum androgen levels and hyperinsulinemia. Images were requested, revealing both enlarged homogeneous and solid ovaries, with preserved adrenal glands, which led to suspicion of a possible thecal hyperplasia of the ovarian stroma. Laparoscopic bilateral adnexectomy was performed and the pathological report confirmed the presumptive diagnosis. One month later after surgery, serum testosterone levels returned to values close to spected for a postmenopausal woman. Finding the source of virilization in postmenopausal women is challenging, and they are usually associated with rare pathologies. A detailed medical history is essential to differentiate the progressive development of virilization that characterizes benign causes from the rapid progression that characterizes malignant tumors. The adequate interpretation of laboratory tests with complementary images, as well as looking for the association of pathologies causing elevated cardiovascular risk such as diabetes and hypertension are essential to establish a right diagnosis and treatment.
Topics: Female; Humans; Hyperplasia; Metabolic Diseases; Postmenopause; Retrospective Studies; Virilism
PubMed: 34181829
DOI: 10.31053/1853.0605.v78.n2.32136 -
Canadian Medical Association Journal Mar 1973A description is briefly given of a patient whose pregnancy was complicated by an ovarian thecoma which ruptured spontaneously.Eleven previously reported instances of...
A description is briefly given of a patient whose pregnancy was complicated by an ovarian thecoma which ruptured spontaneously.Eleven previously reported instances of the combination of thecoma and pregnancy are summarized.Although the present case appears to be the first in which the mother has survived rupture of the tumour, in view of the result to the child this can hardly be claimed as a triumph of obstetrics.
Topics: Adult; Female; Humans; Ovarian Neoplasms; Pregnancy; Pregnancy Complications; Thecoma
PubMed: 4347633
DOI: No ID Found -
The American Journal of Pathology Jun 1977
Review
Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adrenal Rest Tumor; Brenner Tumor; Carcinoma; Disorders of Sex Development; Dysgerminoma; Endometriosis; Female; Fibroma; Granulosa Cell Tumor; Hormones, Ectopic; Humans; Leydig Cell Tumor; Ovarian Neoplasms; Ovary; Sertoli Cell Tumor; Sertoli-Leydig Cell Tumor; Teratoma; Thecoma
PubMed: 194486
DOI: No ID Found -
World Journal of Clinical Cases Jul 2021Meigs syndrome is a rare neoplastic disease characterized by the triad of benign solid ovarian tumor, ascites, and pleural effusion. In postmenopausal women with pleural...
BACKGROUND
Meigs syndrome is a rare neoplastic disease characterized by the triad of benign solid ovarian tumor, ascites, and pleural effusion. In postmenopausal women with pleural effusions, ascites, elevated CA-125 level, and pelvic masses, the probability of disseminated disease is high. Nevertheless, the final diagnosis is based on its histopathologic features following surgical removal of a mass lesion. Here we describe a case of Meigs syndrome with pleural effusion as the initial manifestation.
CASE SUMMARY
A 52-year-old woman presented with a 2-mo history of dry cough and oppression in the chest and was admitted to our hospital due to recurrent pleural effusion and gradual worsening of dyspnea that had occurred over the previous month. Two months before admission, the patient underwent repeated chest drainage and empirical anti-tuberculosis treatment. However, the pleural fluid accumulation persisted, and the patient began to experience dyspnea on exertion leading to admission. A computed tomography scan of the chest, abdominal ultrasound, and magnetic resonance imaging confirmed the presence of right-sided pleural effusion and ascites with a right ovarian mass. Serum tumor markers showed raised CA-125. With a suspicion of a malignant tumor, the patient underwent laparoscopic excision of the ovarian mass and the final pathology was consistent with an ovarian fibrothecoma. On the seventh day postoperation, the patient had resolution of the right-sided pleural effusion.
CONCLUSION
Despite the relatively high risk of malignancy when an ovarian mass associated with hydrothorax is found in a patient with elevated serum levels of CA-125, clinicians should be aware about rare benign syndromes, like Meigs, for which surgery remains the preferred treatment.
PubMed: 34368316
DOI: 10.12998/wjcc.v9.i21.5972