DOCSLIB.ORG

CLÍNICAL CASE Ovarian Steroid Cell Tumor, Not Otherwise 1

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
CLÍNICAL CASE Ovarian Steroid Cell Tumor, Not Otherwise 1 CLÍNICAL CASE Ovarian steroid cell tumor, not otherwise 1. Obstetrics and Gynecology Department, specified, during pregnancy Hospital Central "Dr. Urquinaona", Maracaibo, Zulia, Venezuela. Tumor ovárico de células esteroideas sin a. Doctor in Clinical Medicine b. Doctor in Medical Sciences otra especificación, durante el embarazo c. Physician 1,a 1,b 1,c Declaration of ethical aspects. Eduardo Reyna-Villasmil , Duly Torres-Cepeda , Martha Rondon-Tapia Acknowledgement of authorship: All authors DOI: https://doi.org/10.31403/rpgo.v67i2325 declare that we have contributed to the idea, study design, data collection, data analysis ABSTRACT and interpretation, critical review of the Ovarian steroid cell tumors are classified into stromal luteoma, Leydig cell tumor and steroid cell tumor not otherwise specified, according to their embryonal origin. intellectual content, and final approval of the Ovarian steroid cell tumor not otherwise specified is a rare benign tumor, but manuscript we are submitting. with malignant potential; it accounts for less than 0.1% of all ovarian tumors. They Ethical responsibilities: Protection of persons. should be considered as a cause of virilization in adult women due to testosterone We the authors declare that the procedures production. Only a female fetus is at risk of virilization. Like other ovarian stromal followed conformed to the ethical standards tumors, the tumors must be treated surgically. Surgery is indicated in cases of solid of the responsible human experimentation unilateral ovarian enlargement, due to a 50% chance of malignancy. In pregnancy, ovarian steroid cell tumors not otherwise specified are exceptionally rare and committee and in accordance with the World should be differentiated from luteoma of pregnancy and other malignant ovarian Medical Association and the Declaration of neoplasms. More frequently they may be complicated by rupture and/or torsion. A Helsinki. case of nonspecific ovarian steroid cell tumor during pregnancy is presented. Confidentiality of data: We authors declare Key words: Ovary, Gonadal steroid hormones, Pregnancy, Virilism, Androgens. that we have followed the protocols on the publication of patient data. RESUMEN Los tumores de células esteroides de ovario se clasifican en luteoma estromal, Right to privacy and informed consent: The tumor de células de Leydig y tumor de células esteroideas sin otra especificación, authors have obtained the informed consent según su origen embrionario. El tumor ovárico de células esteroideas sin otra of the patients and/or subjects referred to in especificación es un tumor benigno raro, pero con potencial maligno; representa the article. This document is in the possession menos del 0,1% de todos los tumores de ovario. Deben ser considerados como of the corresponding author. causa de virilización en mujeres adultas por la producción de testosterona. Solo un feto femenino corre riesgo de virilización. Al igual que otros tumores del estroma Financing: The authors certify that we have ovárico, los tumores deben ser tratados quirúrgicamente. La cirugía está indicada en not received financial support, equipment, casos de agrandamiento ovárico unilateral sólido, debido a un 50% de probabilidad personnel or in-kind support from individuals, de malignidad. En el embarazo, los tumores ováricos de células esteroideas sin otra public and/or private institutions for the study. especificación son excepcionalmente raros y deben ser diferenciados del luteoma del embarazo y otras neoplasias malignas del ovario. Con mayor frecuencia pueden Received: 30 August 2020 complicarse con rotura y/o torsión. Se presenta un caso de tumor ovárico de células esteroideas sin otra especificación durante el embarazo. Accepted: 15 November 2020 Palabras clave. Ovario, Hormonas gonadales esteroides, Embarazo, Virilismo, Online publication: Andrógenos. Corresponding author: NTRODUCTION Dr. Eduardo Reyna-Villasmil. I , Hospital Central “Dr. Urquinaona”, Final Av. El Milagro, Maracaibo, Estado Zulia. Steroid cell tumors of the ovary are rare neoplasms of the sex cords. Venezuela They are characterized by proliferation of steroid cells and represent 58162605233 less than 0.1% of all ovarian tumors(1). These lesions can be classified [email protected] m into three subtypes according to cellular origin: stromal luteomas aris- Cite as: Reyna-Villasmil E, Torres-Cepeda D, ing from the ovarian stroma, Leydig cell tumors arising from hilar Leydig Rondon-Tapia. Ovarian steroid cell tumor, cells, and steroid cell tumors not otherwise specified (SCNOS) when the not otherwise specified, during pregnancy. (2). Rev Peru Ginecol Obstet. 2021;67(2). DOI: origin is unknown https://doi.org/10.31403/rpgo.v67i2325 SCNOS should be considered as a cause of hirsutism, temporary bald- ness and amenorrhea in adults. These tumors are rare and should be differentiated from other benign and malignant ovarian neoplasms(2,3). There are few reports of these neoplastic lesions in pregnancy in the literature. We present a case of an otherwise unspecified steroid cell tumor during pregnancy. CASE REPORT A 29-years-old patient, gravida 3, cesarean section 1, abortion 1, with 35 weeks of gestation consulted for presenting excessive hair growth on face, legs and trunk, accompanied by increased libido since the begin- Rev Peru Ginecol Obstet. 2021;67(2) 1 Eduardo Reyna-Villasmil, Duly Torres-Cepeda, Martha Rondon-Tapia ning of pregnancy. She reported menarche at 14 Patient underwent cesarean section 3 weeks years of age and normal menstruation until 25 later and delivered a 3,500-gram live male years of age, which then became irregular. The newborn with Apgar scores of 6 and 9 points pregnancy was spontaneous and the cesarean at 1 minute and 5 minutes respectively. No section was performed for cephalopelvic dis- evidence of macroscopic alterations was ob- proportion without complications, nine years served. During surgery, a left ovarian tumor before. The patient reported regular menstrual measuring 9 x 5 x 4 centimeters with a bright cycles before the current pregnancy. She denied reddish surface and some yellowish areas with any significant personal or family history. signs of diffuse hemorrhage was seen (Figure 1). There was no evidence of ascites or peri- Physical examination revealed body mass index toneal implants. The right uterus and ovary 41.3 kg/m2, blood pressure 130/80 mmHg, an- were normal in appearance and there was no drogenic alopecia, prominent hirsutism on the evidence of peritoneal lesions. Transoperative face, chest, abdomen, back, upper and lower frozen section diagnosed steroid cell tumor limbs (Ferriman-Gallwey score 21/36) and rough with no signs of malignancy. Left oophoro- voice. The abdomen was globular at the expense salpingectomy plus peritoneal lavage, pelvic of a pregnant uterus with a single fetus inside. lymph node biopsy and partial omentectomy Gynecologic evaluation showed clitoromegaly were performed. Both the uterus and the right with a width of 9 millimeters. There was no evi- adnexa were left to preserve fertility. dence of striae, acne, bruising or proximal mus- cle weakness. The pathology examination reported a yellow- ish tumor with several whitish areas, measur- Gestational dating ultrasound showed a single ing approximately 7 centimeters in diameter, live male fetus of size according to gestational with congested vessels, circumscribed to the age, with normal amniotic fluid volume. In addi- ovary and without external excrescences. The tion, there was a solid, homogeneous, well-cir- cut section showed a tumor of friable consis- cumscribed tumor in the left adnexa measuring tency. On microscopic examination, tumor 9 x 8 x 6 centimeters, with high vascularization. was well encapsulated, composed of large The abdomino-pelvic MRI revealed normal kid- and small lobules of large polygonal cells with neys and adrenal glands and a solid tumor centrally located small round-ovate nuclei; eo- measuring 8 x 6 centimeters in the left ovary, sinophilic granular chromatin and abundant heterogeneous, surrounded by normal ovarian eosinophilic cytoplasm separated by a dense follicles. There was no evidence of adrenal tu- vascular network. Most cells showed foamy mor on other location, metastases, ascitic fluid, cytoplasm, consistent with the presence of lip- retroperitoneal or pelvic lymphadenopathy. ids. No components suggestive of fibroma, sig- FIGURE 1. INTRAOPERATIVE FINDING OF THE LEFT OVARIAN TUMOR. Laboratory tests showed increased testosterone serum concentrations of 6.7 ng/mL (normal val- ue 0.4 to 0.76 ng/mL) and 4-androstenedione 3.5 ng/mL (normal value: 0.4 to 3.4 ng/mL). Serum concentrations of estradiol, prolactin, cortisol, free thyroxine and of thyrostimulating hormone were within normal limits. Hematologic and bio- chemical test results were also normal. Chorion- ic gonadotropin values 35 000 mIU/mL (normal value 940 to 60,000 mIU/mL), CA-125 30 IU/mL (normal value less than 35 IU/L), CA19-9 30 U/L (normal value less than 37 IU/L), carcinoembry- onic antigen 2 ng/mL (normal value less than 2.5 ng/mL) and alpha-fetoprotein 50 ng/mL (normal value 10 to 230 ng/mL in the third trimester of pregnancy) were within normal limits. The con- sensus of the gynecologic oncology team was to perform a surgical exploration of the tumor. 2 Rev Peru Ginecol Obstet. 2021;67(2) Ovarian steroid cell tumor, not otherwise specified, during pregnancy nificant necrosis, hemorrhage, mitotic activity, Serum androgen concentrations decreased to high-grade nuclear atypia,
Load more

Recommended publications
  • Pregnancy Luteoma Along with Benign Cystic Teratoma: a Case Report
    ISSN: 0975-8585 Research Journal of Pharmaceutical, Biological and Chemical Sciences Pregnancy Luteoma Along With Benign Cystic Teratoma: A Case Report. Vijay Kumar Bodal1*, Manjit Singh Bal1, Sarbhjit Kaur2, Manjit Kaur Mohi2, Anudeep Gill1, and Mohanvir Kaur1. 1Department of Pathology, Government Medical College, Patiala, Punjab, India. 2Department of Obstetrics and Gynecology, Government Medical College, Patiala, Punjab, India. ABSTRACT It is a rare to find simultaneous benign cystic teratoma and pregnancy luteoma in an ovary. Mature cystic teratoma is the most common type of ovarian germ cell neoplasm. About 0.8% to 12.8% of reported cases of mature cystic teratorma have occurred during pregnancy. Pregnancy luteoma is a distinctive, non- neoplastic lesion of pregnancy, characterized by solid proliferation of luteinized cells, and tumour-like ovarian enlargement that regresses during puerperium. To date fewer than 200 cases of pregnancy luteoma have been reported. We presented a rare case of a multiparous 26 year old gravid female who presented with mass and moderate pain in abdomen. Keywords: pregnancy, luteoma, teratoma, benign cyst. *Corresponding author March - April 2014 RJPBCS 5(2) Page No. 1593 ISSN: 0975-8585 CASE HISTORY A 26 years old female, gravida 3 para 2, presented with amenorrhea since 3 months and palpabel mass with moderate pain in the abdomen for 2 months. Clinical and radiological diagnosis of dermoid cyst ovary was made and intrauterine pregnancy was confirmed on ultrasound. Laparotomy was done and ovarian mass was removed which was subjected to histopathological examination. RESULTS On gross examination the mass was in the form of globular gray-white, gray-brown soft tissue measuring 7×5×4 cm in size.
    [Show full text]
  • CLINICAL IMAGE a Metastatic Ovarian Tumor Mimicking
    Magn Reson Med Sci, Vol. XX, No. X, pp. XXX–XXX, 2015 ©2015 Japanese Society for Magnetic Resonance in Medicine E-pub ahead of print by J-STAGE CLINICAL IMAGE doi:10.2463/mrms.ci.2015-0034 A Metastatic Ovarian Tumor Mimicking Pregnancy Luteoma Found during Puerperium Yumiko OISHI TANAKA1*, Satoshi OKADA2,3, Akiko SAKATA4, Tsukasa SAIDA1, Michiko NAGAI1, Hiroyuki YOSHIKAWA3, Masayuki NOGUCHI4, and Manabu MINAMI1 Keywords: metastatic ovarian tumor, pregnancy, The white-colored small right ovarian mass with hem- pregnancy luteoma, sclerosing stromal tumor, MRI orrhage surrounded by the pseudo-cyst was removed (Fig. 1E). The tumor was composed of varying types (Received March 31, 2015; Accepted July 20, 2015; of malignant tumors including signet ring-like cells published online December 28, 2015) (Fig. 1F) and was positive for CDX2. The histopatho- logical diagnosis was metastatic adenocarcinoma of the ovary and its peritoneal dissemination. Advanced Introduction rectal cancer was also found via colonic fiberscope Pregnancy luteoma is a benign condition observed followed by the surgery. As the disease was resistive during pregnancy. We introduce a case with a meta- against chemotherapy, the patient was transferred to static ovarian tumor mimicking pregnancy luteoma on another hospital under best supportive care. magnetic resonance. Discussion Case Report Common malignant ovarian tumors found during A 28-year-old puerperant with fever came to our pregnancy include mature cystic teratomas, epithelial hospital. Her last delivery was uneventful. Her labo- carcinomas, yolk-sac tumors, immature teratomas, and ratory data was normal except for anemia (red blood Sertoli-cell tumors. Metastatic ovarian tumor during cell count was 3.41 × 106/μl) and elevated serum pregnancy is not so rare.1 Their diagnosis often delays C-reactive protein (7.23 mg/dl).
    [Show full text]
  • Progesterone-Responsive Vaginal Leiomyoma and Hyperprogesteronemia Due to Ovarian Luteoma in an Older Bitch L
    Ferré-Dolcet et al. BMC Veterinary Research (2020) 16:284 https://doi.org/10.1186/s12917-020-02507-z CASE REPORT Open Access Progesterone-responsive vaginal leiomyoma and hyperprogesteronemia due to ovarian luteoma in an older bitch L. Ferré-Dolcet* , S. Romagnoli, T. Banzato, L. Cavicchioli, R. Di Maggio, A. Cattai, M. Berlanda, M. Schrank and A. Mollo Abstract Background: This is the first report about a vaginal leiomyoma concomitant with an ovarian luteoma in a bitch. Case presentation: A 11-year-old intact female Labrador retriever was referred because of anuria, constipation and protrusion of a vaginal mass through the vulvar commissure. The bitch had high serum progesterone concentration (4.94 ng/ml). Because of the possibility of progesterone responsiveness causing further increase of the vaginal mass and since the bitch was a poor surgical candidate a 10 mg/kg aglepristone treatment was started SC on referral day 1. A computerized tomography showed a 12.7 × 6.5 × 8.3 cm mass causing urethral and rectal compression, ureteral dilation and hydronephrosis. A vaginal leiomyoma was diagnosed on histology. As serum progesterone concentration kept increasing despite aglepristone treatment, a 0.02 ng/mL twice daily IM alfaprostol treatment was started on day 18. As neither treatment showed remission of clinical signs or luteolysis, ovariohysterectomy was performed on referral day 35. Multiple corpora lutea were found on both ovaries. On histology a luteoma was diagnosed on the left ovary. P4 levels were undetectable 7 days after surgery. Recovery was uneventful and 12 weeks after surgery tomography showed a reduction of 86.7% of the vaginal mass.
    [Show full text]
  • Endometrial Carcinoma Uterus
    5/23/2014 Common gynecologic intraoperative consults • Uterus - Endometrial carcinoma Common pitfalls in the evaluation - Myometrial mass of gynecologic frozen sections • Ovary - Benign versus borderline versus carcinoma Karuna Garg, MD - Primary versus metastasis • Vulva University of California San Francisco - Margin evaluation • Others (cervix, peritoneum etc) Uterus: Endometrial carcinoma • Rationale for FS? To stage or not to stage Uterus: Endometrial carcinoma - All high risk patients are staged (FIGO grade 3 endometrioid, non endometrioid histologies) - What about apparent low risk endometrial cancer? Staging in selective patients based on FS findings 1 5/23/2014 Endometrial carcinoma Endometrial carcinoma Treatment decisions based on FS Accuracy of frozen sections: - Lymphadenectomy or not - Variable (from very good to very poor) - Extent of lymphadenectomy - Omentectomy and/or pelvic biopsies - Sentinel lymph nodes for endometrial cancer Endometrial carcinoma Features to evaluate at FS • Tumor grade • Myometrial invasion • Lymphovascular invasion • Of 784 patients, 10 (1.3%) had a potential change in operative strategy because of a deviation in Cervical or adnexal involvement results from frozen sections to paraffin sections. Sanjeev Kumar , Fabiola Medeiros , Sean C. Dowdy , Gary L. Keeney , Jamie N. Bakkum-Gamez , Karl C. Podratz , Will... A prospective assessment of the reliability of frozen section to direct intraoperative decision making in endometrial cancer • Tumor size (2 cm)? Gynecologic Oncology, Volume 127, Issue 3, 2012, 525 - 531 http://dx.doi.org/10.1016/j.ygyno.2012.08.024 2 5/23/2014 Endometrial carcinoma: Treatment decisions? Endometrial carcinoma 1. Hysterectomy alone: How to approach specimen: - Grade 1 endometrioid, no myoinvasion or LVI - Bivalve uterus and serial section every 5 mm 2.
    [Show full text]
  • Ovarian Tumors
    Ovarian Tumors 803-808-7387 www.gracepets.com These notes are provided to help you understand the diagnosis or possible diagnosis of cancer in your pet. For general information on cancer in pets ask for our handout “What is Cancer”. Your veterinarian may suggest certain tests to help confirm or eliminate diagnosis, and to help assess treatment options and likely outcomes. Because individual situations and responses vary, and because cancers often behave unpredictably, science can only give us a guide. However, information and understanding for tumors in animals is improving all the time. We understand that this can be a very worrying time. We apologize for the need to use some technical language. If you have any questions please do not hesitate to ask us. What are the ovarian tumors? The ovary contains several different cell types. These include the germ cells, which make the eggs, the supporting (stromal) and hormone-producing cells as well as epithelium, connective tissue and blood vessels. Any or all of these cell types may become cancerous. When germ cells become cancerous, the tumors are called dysgerminomas. Tumors of ovarian stromal cells include granulosa cell tumors, thecomas and interstitial cell tumors (luteomas). These tumour types overlap and they may occur singly or in any combination. Epithelial tumors include papillary adenoma and adenocarcinomas. Rare types of ovarian tumour include the teratoma formed by embryonic germ (primitive) cells that develop abnormally to produce many different tissues. Some ovarian cancers are benign and others malignant. In some cases, removal of the affected ovary will be curative. Spread to other internal organs (metastasis) is possible with some types, particularly Reproductive Anatomy the larger tumors.
    [Show full text]
  • Ovarian Tumors in Children and Adolescents Linah Al-Alem University of Kentucky, [email protected]
    University of Kentucky UKnowledge Pediatrics Faculty Publications Pediatrics 2010 Ovarian Tumors in Children and Adolescents Linah Al-Alem University of Kentucky, [email protected] Amit M. Deokar University of Kentucky Rebecca Timme University of Kentucky Hatim A. Omar University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits oy u. Follow this and additional works at: https://uknowledge.uky.edu/pediatrics_facpub Part of the Obstetrics and Gynecology Commons, and the Pediatrics Commons Repository Citation Al-Alem, Linah; Deokar, Amit M.; Timme, Rebecca; and Omar, Hatim A., "Ovarian Tumors in Children and Adolescents" (2010). Pediatrics Faculty Publications. 258. https://uknowledge.uky.edu/pediatrics_facpub/258 This Book Chapter is brought to you for free and open access by the Pediatrics at UKnowledge. It has been accepted for inclusion in Pediatrics Faculty Publications by an authorized administrator of UKnowledge. For more information, please contact [email protected]. Ovarian Tumors in Children and Adolescents Notes/Citation Information Published in Pediatric and Adolescent Sexuality and Gynecology: Principles for the Primary Care Clinician. Hatim A. Omar, Donald E. Greydanus, Artemis K. Tsitsika, Dilip R. Patel, & Joav Merrick, (Eds.). p. 597-627. © 2010 Nova Science Publishers, Inc. The opc yright holder has granted the permission for posting the book chapter here. This book chapter is available at UKnowledge: https://uknowledge.uky.edu/pediatrics_facpub/258 In: Pediatric and Adolescent Sexuality... ISBN: 978-1-60876-735-9 Ed: H. A. Omar et al. © 2010 Nova Science Publishers, Inc. Chapter 11 OVARIAN TUMORS IN CHILDREN AND ADOLESCENTS Linah Al-Alem, MSc, Amit M.
    [Show full text]
  • Adnexal Masses in Pregnancy
    A guide to management Mitchel S. Hoffman, MD Professor and Director, Division of Adnexal masses in pregnancy Gynecologic Oncology, Department of Obstetrics and Gynecology, Forego surgery in most cases until delivery—or until University of South Florida, Tampa, Fla Robyn A. Sayer, MD the risky fi rst trimester has passed Assistant Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, CASE 1 An enlarging cystic tumor 16 × 12 × 4 cm and determined that it University of South Florida, Tampa, Fla was a corpus luteum cyst. The authors report no fi nancial relationships relevant to this article. A 20-year-old gravida 3 para 1011 visits the emergency department with persistent right Presence of mass raises questions fl ank pain. Although ultrasonography (US) Despite the rarity of malignancy, the dis- shows a 21-week gestation, the patient has covery of an ovarian mass during pregnan- had no prenatal care. Imaging also reveals a® Dowdency prompts several Health important Media questions: right-sided ovarian tumor, 14 × 11 × 8 cm, How should the mass be assessed? How that is mainly cystic with some internal can the likelihood of malignancy be deter- echogenicity. CopyrightFor personalmined as quickly use and only effi ciently as pos- At 30 weeks’ gestation, a gynecologic sible, without jeopardy to the pregnancy? oncologist is consulted. Repeat US reveals When is surgical intervention warranted? the mass to be about 20 cm in diameter and And when can it be postponed? Specifi - cystic, without internal papillation. The pa- cally, is elective operative intervention for IN THIS ARTICLE tient’s CA-125 level is 12 U/mL.
    [Show full text]
  • Association Between Ovarian Tumors and Uterine Endometrial Lesions in Rats*
    J Toxicol Pathol 5: 215•`222, 1992 ASSOCIATION BETWEEN OVARIAN TUMORS AND UTERINE ENDOMETRIAL LESIONS IN RATS* Hiroshi Onodera, Yuko Matsushima, and Kunitoshi Mitsumori Division of Pathology, Biological Safety Research Center, National Institute of Health Sciences Takaharu Nagaoka Research Laboratories, Yoshitomi Pharmaceutical Industries Ltd. Tsuyoshi Kitamura, Jin Lu, and Akihiko Maekawa Department of Pathology, Sasaki Institute Abstract: Granulosa cell tumors/luteomas of the ovary were induced at very high incidence in the offspring of F344 rats receiving N-nitrosobis (2-oxopropyl)amine (BOP) transplacentally (Jpn. J. Cancer Res., 81: 1077-1080, 1990). In addition to ovarian tumors, atrophic and hyperplastic lesions were also frequently observed in the ovary and uterus of BOP-treated animals, respectively. In order to investigate the relation between granulosa cell tumors and uterine endometrial lesions, the lesions in BOP-treated rats with ovarian tumors were compared to those in the rats without tumors. While no endometrial adenocarcinoma was found in both rat groups, the incidence and degree of atypical, and adenomatous endometrial hyperplasias were slightly high in rats with ovarian tumors, as compared to rats without tumors, while being not significant. In the assay of plasma gonad steroids, hormonal imbalance was clearly detected in BOP-treated animals and the 17ƒÀ-estradiol: progesterone (E2: P) ratio was higher in BOP-treated rats with ovarian tumors than control rats or treated rats without tumors. These results suggest that a slight association between ovarian tumors and endometrial proliferative lesions exists in rats and hormonal imbalance, particularly an increased E2: P ratio, might play an important role in the association.
    [Show full text]
  • Benin Tumors of the Uterus and the Ovary
    Benign tumors of women’s reproductive system PLAN OF LECTURE 1. Benign tumors of the uterus • Etiopathogenesis • Classification • Clinical symptoms • Diagnostics • Management 2. Benign ovarian tumors • Etiopathogenesis • Classification • Clinical symptoms • Diagnostics • Management Leiomyoma smooth muscule + fibrous connective tissue Frequency of uterine myoma makes 15-25% among women after 35-40 years Etiopathogenesis myoma - mesenchymal tumor (region of active growth formation around the vessels growing of tumor) + hyperoestrogenism Myomas are rarely found before puberty, and after menopause. The association of fibroids in women with hyperoestrogenism is evidenced by endometrial hyperplasia, abnormal uterine bleeding and endometrial carcinoma. Myomas increase in size: during pregnancy, with oral contraceptives, after delivery. Accoding to Location of uterus myomas Hysteromyoma classification: • А. By the node localization: 1. subserous – growth in the direction of the perimetrium; 2. intramural (interstitial) – growth into the thickness of the uterine wall; 3. submucous – node growth into the uterine cavity; 4. atypical – retrocervical, retroperitoneal, antecervical, subperitoneal, perecervical, intraligamentous. • В. By the node size (small, medium, and large) • C. By the growth form • (false – conditioned by blood supply disturbance and edema, and true – caused by the processes of smooth muscle cells proliferation). • D. By the speeding of the growth (fast and slowly) The symptoms of uterine fibroids Fibroids can also cause a number
    [Show full text]
  • Unilateral Luteoma of the Ovary in a Pregnant Risso’S Dolphin (Grampus Griseus)
    NOTE Pathology Unilateral luteoma of the ovary in a pregnant Risso’s dolphin (Grampus griseus) Hironobu NISHINA1), Takeshi IZAWA1)*, Miki OZAKI2), Mitsuru KUWAMURA1) and Jyoji YAMATE1) 1)Laboratory of Veterinary Pathology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai-Kita, Izumisano, Osaka 598-8531, Japan 2)Adventure World AWS Co., Ltd., 2399 Nishimuro-gun, Shirahama-cho, Katada, Wakayama 649-2201, Japan ABSTRACT. A white, lobular mass was found in the right ovary of a pregnant Risso’s dolphin (Grampus griseus) at necropsy. The mass was unilateral and occupied most of the pre-existing ovarian tissue. Histologically, the mass was composed of diffuse sheets of polyhedral cells with J. Vet. Med. Sci. abundant eosinophilic cytoplasm and oval nuclei, separated by fibrous connective tissue. Only 79(10): 1749–1752, 2017 a few ovarian follicles were observed at the periphery of the mass. Immunohistochemically, the large eosinophilic cells were positive for vimentin and negative for pan-cytokeratins. Based on doi: 10.1292/jvms.17-0172 the histopathological features, the present case was diagnosed as luteoma. In human medicine, luteoma of pregnancy, a tumor-like proliferative lesion occurring in pregnant women, is well described. In veterinary medicine, luteoma associated with pregnancy has never been described. Received: 9 April 2017 The present study would provide useful information for understanding the characteristics of Accepted: 9 August 2017 luteoma in animals. Published online in J-STAGE: KEY WORDS: dolphin, luteoma, ovary, pregnancy, sex cord-stromal tumor 27 August 2017 In veterinary literature, ovarian tumors are divided into 3 broad categories: tumors of the surface celomic epithelium, tumors of the sex cord and gonadal stroma, and tumors of germ cells [10].
    [Show full text]
  • Ovarian Tumors Histogenesis and Systemic Effects
    Ovarian Tumors Histogenesis and Systemic Effects H. FOX, M.D., San Francisco * Sufficient histologic and embryologic information is now available to allow for a reasonably satisfactory histogenic classification of ovarian neoplasms. The majority of these tumors are derived from germ cells, sex cord-mesenchyme or the germinal epithelium. A few, such as the Brenner tumor, must stiU be classed as being of "uncertain histogenesis," for the cell (or tissue) of origin is not yet known. It is now realized that many ovarian neoplasms previously considered to be endocrinologically inert may, on occasion, be associated with either estrogenic or androgenic activity. This applies particularly to Brenner tumors, mucinous cystadenomas and serous cystadenomas. The common factor associated with such endocrine activity is luteinization of the tumor stroma. Ovarian neoplasms usually manifest only local symptoms, but they may, on occasion, be associated with such unusual systemic effects as hypoglycemia, hypercalcemia or a hemolytic anemia. THIS REVIEW PRESENTS a classification of primary accepted for no other hypothesis can explain either ovarian tumors that is based on current histogene- the dominance of the gonads as a site for such tic concepts; it is not proposed to discuss each neoplasms or the finding that whilst ovarian tera- tumor but to consider briefly only those neoplasms tomas are invariably sex chromatin positive, those about which fresh information has accrued in occurring in the testis may show either a male or recent years and to review also recent data con- a female sex chromatin pattern.46 The question cerning systemic manifestations of ovarian tumor. whether a teratoma develops by fusion of two with neoplastic transformation of the A.
    [Show full text]
  • CLINICAL IMAGE a Metastatic Ovarian Tumor
    Magn Reson Med Sci, Vol. 15, No. 2, pp. 149–150, 2016 doi:10.2463/mrms.ci.2015-0034 ©2015 Japanese Society for Magnetic Resonance in Medicine CLINICAL IMAGE A Metastatic Ovarian Tumor Mimicking Pregnancy Luteoma Found during Puerperium Yumiko Oishi TANAKA1*, Satoshi OKADA2,3, Akiko SAKATA4, Tsukasa SAIDA1, Michiko NAGAI1, Hiroyuki YOSHIKAWA3, Masayuki NOGUCHI4, and Manabu MINAMI1 Keywords: metastatic ovarian tumor, pregnancy, The white-colored small right ovarian mass with hem- pregnancy luteoma, sclerosing stromal tumor, MRI orrhage surrounded by the pseudo-cyst was removed (Fig. 1E). The tumor was composed of varying types (Received March 31, 2015; Accepted July 20, 2015; of malignant tumors including signet ring-like cells published online December 28, 2015) (Fig. 1F) and was positive for CDX2. The histopatho- logical diagnosis was metastatic adenocarcinoma of the ovary and its peritoneal dissemination. Advanced Introduction rectal cancer was also found via colonic fiberscope Pregnancy luteoma is a benign condition observed followed by the surgery. As the disease was resistive during pregnancy. We introduce a case with a meta- against chemotherapy, the patient was transferred to static ovarian tumor mimicking pregnancy luteoma on another hospital under best supportive care. magnetic resonance. Discussion Case Report Common malignant ovarian tumors found during A 28-year-old puerperant with fever came to our pregnancy include mature cystic teratomas, epithelial hospital. Her last delivery was uneventful. Her labo- carcinomas, yolk-sac tumors, immature teratomas, and ratory data was normal except for anemia (red blood Sertoli-cell tumors. Metastatic ovarian tumor during cell count was 3.41 × 106/μl) and elevated serum pregnancy is not so rare.1 Their diagnosis often delays C-reactive protein (7.23 mg/dl).
    [Show full text]