Adult-Type Granulosa Cell Tumor with Similar Clinical Findings Seen during Ovarian Cystectomy Performed at the Same Time as Laparoscopic Ovarian Drilling for Polycystic Ovarian Syndrome: An Extremely Rare Case

Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.

Granulosa Cell Tumors of the Ovary: Retrospective Analysis of 17 Cases

Background: Granulosa cell tumors (GCTs) are rare neoplasms with a relatively favorable prognosis. They are characterized by a prolonged history and a tendency to late recurrences. It is the most common type of sex cord-stromal tumors. Aims: To analyze, to report and to better understand the clinico-pathologic features and results of treatment, and prognostic factors of these tumors. Materials and Methods: A retrospective single-institutional review 17 cases of GCTs were treated in National Cancer Institute—Cairo University from January 2010 till December 2014. The clinical and pathological characteristics, treatment, and outcomes of patients with ovarian GCTs were analyzed. Results: Data from 17 patients were obtained. The median age was 54 years (range;14 - 72). Abdominal pain was the most common presentation (64.7%). The mean tumor size was 14 cm (range;7 - 23 cm). The majority of our patients were stage I (n = 11;64.7%), while (n = 3;17.6%) had stage III and (n = 2, 11.8%) were stage IV. Only one case (5.9%) had an unknown stage (explored outside NCI). The majority of cases were of adult type disease (n = 14) and low grade pathology (n = 10). In follow-up period (median = 42 months;ranging 9 - 60) three patients relapsed;the median overall survival time was not reached yet, however, the estimated 3-year survival was 72.5%. Conclusion: Granulosa cell tumors are rare neoplasms of the ovaries. They progress slowly and often are diagnosed in an early stage. Surgery is the main line of treatment. Prolonged post-therapeutic follow-up is necessary. Definition of proper prognostic factors is mandatory.

Meigs’syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions:A case report

BACKGROUND Meigs’syndrome is regarded as a benign ovarian tumor accompanied by pleural effusion and ascites,both of which resolve after removal of the tumor.Patients often seek treatment in the Department of Respiratory and Critical Care Medicine or other internal medicine departments due to symptoms caused by ascites or hydrothorax.Here,we report a rare case of Meigs'syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions.CASE SUMMARY A 52-year-old women was admitted to the Department of Respiratory and Critical Care Medicine due to coughing and expectoration accompanied with shortness of breath.Chest X-ray and chest computed tomography showed a modest volume of pleural fluid with pleural thickening in the right lung.The carbohydrate antigen 125(CA125)concentration was 150.8 U/mL(normal,0-35 U/mL)and no tumor cells were observed in pleural fluid.Nodules and a neoplasm with a fish meat-like appearance in the parietal pleura and nodules with a‘string of beads’-like appearance in the diaphragm were found by thoracoscopic examination.Furthermore,pelvic magnetic resonance revealed a pelvic mass measuring about 11.6 cm×10.0 cm×12.4 cm with heterogeneous signal intensity and multiple hypointense separations.Total abdominal hysterectomy,bilateral adnexectomy,and separation of pelvic adhesion were performed under general anesthesia.The pathology results showed granulosa cell tumor.At the 2-mo follow-up after the surgery,the hydrothorax subsided,and the CA125 level returned to normal.CONCLUSION For postmenopausal women with unexplained hydrothorax and elevated CA125,in addition to being suspected of having gynecological malignancy,Meigs’syndrome should be considered.

Atypical presentation and localization of granulosa cell tumor—A case report and review of the literature

Introduction: Extraovarian granulosa cell tumor (GCT) is a very uncommon tumor, assumed to arise from the ectopic gonadal tissue along the embryonal route of the genital ridge. Case report: We report the case of a 25 year-old woman who was presented at the emergency unit with a severe abdominal pain focused on the left iliac fossa. The patient had delivered normally 2 months before. An ovarian mass of 79 × 67 × 89 mm was shown in vaginal ultrasound as well as at the abdominal scan. Exploratory laparoscopy was performed and a torsion of the fallopian tube and an hemato-salpinges was visualized. Re-vascularisation was not achieved and a left salpingectomy took place. The immuno-histopathology report revealed an extra-ovarian GCT deriving from the fimbriae of the tube. Follow-up surgery was discussed. The case is presented for its rarity.

Investigation of the Cause of Precocious Puberty in an 8-Year-Old Girl Ended up in Juvenile Granulosa and Theca Cell Tumor of the Ovary

Isosexual precocious puberty in girls has several etiologies. Juvenile granulose cell tumor is one of the rarest causes that only stands for 1.5% of ovarian cancers. This tumor mostly encounters in first 2 decades of life. This paper is a report of an 8-year-old girl with precocious puberty that within five months developed breast enlargement followed by menarche. Works which are done to find the underlying cause of precocious puberty revealed juvenile granulosa cell tumor in her left ovary. She then under went laparoscopic surgery and 3 courses of chemotherapy. She did not experience any vaginal bleeding after that and the serum level of estradiol lay among its normal ranges, but after that the tumor relapsed and presented as abdominal pain and a huge mass which under went resection of all afflicted tissues. After 2 courses of chemotherapy, her status deteriorated and unfortunately she died after 6 months from the time of diagnosis. Treatment for this disease is consists of resection surgery and chemotherapy. If this tumor is diagnosed in its early stages, it will be curable, but in its advanced stages, up to 80% of patients die from recurrent tumors. The reported patient was diagnosed at stage IIIC that had poor prognosis.

Adult Granulosa Cell Tumor in a Young Woman: A Case Report and Literature Review

Granulosa cell tumors belong to the group of stromal and sex cord tumors of the ovary. The adult type is the most common type and usually occurs during the perimenopausal period while the juvenile type mostly affects young women. This is a report of a 26 years old woman who presented an adult type of granulosa cells tumor, with review of the literature. She complained abdominal pain and distension associated with abundant ascites and underwent a right adnexectomy. The pathology examination diagnosed an adult granulosa cell tumor. The two entities of granulosa cell tumors (juvenile and adult types) are distinguished by their characteristic morphological aspects on histological examination allowing diagnostic orientation.

Apoptosis and Expression of Protein TRAIL in Granulosa Cells of Rats with Polycystic Ovarian Syndrome

The relationship between apoptosis of granulosa cells and follicle development arrest in polycystic ovarian syndrome (PCOS) rats, and the contribution of tumor necrosis factor related apoptosis inducing ligand (TRAIL) in apoptosis of granulosa cells were explored. By using sodium prasterone sulfate rat PCOS model was induced. The apoptosis of granulosa cells in ovaries of rats was observed by TdT-mediated dUTP-biotin nick end-labeling (TUNEL), and the expression of TRAIL protein and mRNA in granulosa cells was detected by using immunhistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) respectively. The apoptotic rate and the expression of protein TRAIL in granulosa cells were significantly higher in antral follicles from the PCOS rats than in those from the control rats (P<0.01, P<0.05). There was no significant difference in apoptotic rate and the expression of TRAIL protein in granulosa cells of preantral follicles between the PCOS rats and the control rats (P>0.05). No apoptosis and the expression of TRAIL protein in granulosa cells of primordial follicles were found in the two groups. The expression of TRAIL mRNA was significantly stronger in granulosa cells from the PCOS rats than in those from the con- trol rats (P<0.01). It was suggested that the apoptotic rate in granulosa cells was significantly higher in antral follicle from the PCOS rats than in those from the control rats. TRAIL played a role in regu- lating the apoptosis of granulosa cells in PCOS rats.

Prediction of radiosensitivity in primary central nervous system germ cell tumors using dynamic contrast-enhanced magnetic resonance imaging

Objective： To evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging（DCEMRI） for predicting tumor response to radiotherapy in patients with suspected primary central nervous system（CNS） germ cell tumors（GCTs）.Methods： DCE-MRI parameters of 35 patients with suspected primary CNS GCTs were obtained prior to diagnostic radiation, using the Tofts and Kermode model. Radiosensitivity was determined in tumors diagnosed 2 weeks after radiation by observing changes in tumor size and markers as a response to MRI. Taking radiosensitivity as the gold standard, the cut-off value of DCE-MRI parameters was measured by receiver operating characteristic（ROC） curve. Diagnostic accuracy of DCE-MRI parameters for predicting radiosensitivity was evaluated by ROC curve.Results： A significant elevation in transfer constant（K^trans） and extravascular extracellular space（Ve）（P=0.000）, as well as a significant reduction in rate constant（Kep）（P=0.000） was observed in tumors. K^trans, relative K^trans, and relative Kep of the responsive group were significantly higher than non-responsive groups. No significant difference was found in Kep, Ve, and relative Ve between the two groups. Relative K^trans showed the best diagnostic value in predicting radiosensitivity with a sensitivity of 100%, specificity of 91.7%, positive predictive value（PPV） of 95.8%, and negative predictive value（NPV） of 100%.Conclusions： Relative K^trans appeared promising in predicting tumor response to radiation therapy（RT）. It is implied that DCE-MRI pre-treatment is a requisite step in diagnostic procedures and a novel and reliable approach to guide clinical choice of RT.

Localized Giant Cell Tumor of the Tendon Sheath: A Rare Case of Anterior Knee Pain

This report describes a 61-year-old female with a giant cell tumor of the tendon sheath (GCT-TS). MRI showed that an elliptical abnormal signal was observed over the infrapatellar region of the right knee. We directly do arthroscopy to remove the tumor. An oval irregular mass of about 2.0 cm × 1.5 cm × 1 cm in the right knee joint was found. It was hard and had a dark red surface and the pedicle of the mass was connected with the joint capsule and infrapatellar fat pad. Nodular GCT-TS occurs less frequently in large joints than the small joints of the fingers and toes. The current report demonstrates the unique characteristics of the GCT-TS that extends around the ankle and invades the knee and proximal humerus.

Giant cell tumor involving radial diaphysis

Giant cell tumor (GCT) of the bone is a benign but locally aggressive & destructive lesion. This tumor is usually seen in patients over 20 years of age. Less than 2% are found in part with open epiphysis. The epiphyseal portion of the bone is characteristic site of giant cell tumor. In rare instances, giant cell tumor can occur in the diaphysis of long tubular bone without involving the epiphysis. Although age, clinical and radiological features are helpful, it is still the histology that helps to clinch the diagnosis. It is important to distinguish giant cell tumor of diaphysis from the giant cell rich lesions, more common in this site.

儿童声带颗粒细胞瘤2例临床特征分析

目的:分析儿童声带颗粒细胞瘤(GCT)的临床特征。方法:回顾性分析2013年1月至2023年12月西安交通大学第二附属医院收治的2例儿童声带GCT患者的临床资料。结果:病例1,女,6岁,因“发声无力3月余”入院,喉镜提示声门下弥漫性膨隆,颈部增强CT提示前联合下方低密度结节并渐进性强化;患儿在全麻下行支撑喉镜CO_(2)激光切除术,术后病理确诊GCT;术后1个月至术后2年复查,肿物无复发,术区局部瘢痕形成,但无明显黏连,声门闭合可。病例2,女,11岁,因“声嘶半年余”入院,喉镜提示前联合光滑肿物,颈部增强CT及喉部增强MRI提示前联合强化结节;患儿在全麻下行支撑喉镜CO_(2)激光切除术,术后病理确诊GCT,术后2周至术后1年复查,肿物无复发,声门下瘢痕形成,声门闭合良好。结论:儿童声带GCT常表现为发音异常,需依靠病理确诊;手术切除为其主要治疗方法,术后应密切随访。

卵巢颗粒细胞瘤8例临床病理观察并文献复习

目的:探讨卵巢颗粒细胞瘤的临床病理特征、诊断、鉴别诊断及预后。方法:收集本院2013-2023年诊断为卵巢颗粒细胞瘤的病例8例。分析其临床病理学特征及免疫组化表型,并复习相关文献。结果:8例平均年龄54岁,均手术治疗,除1例8年后复发死亡外,其余均存活。肿瘤平均大小10.38cm,呈囊性、多房囊性或实性。镜下肿瘤呈弥漫、实性排列,也可见假乳头状、岛状、巢团状、被富于细胞的纤维间质分隔。免疫组化显示肿瘤细胞α-Inhibin、Vimentin、CD99阳性,EMA、CK7阴性。结论:卵巢颗粒细胞瘤是低度恶性肿瘤,镜下表现方式多样,免疫组化染色及基因检测可协助诊断。手术治疗是主要方式,存在远期复发可能,需要定期随诊。

卵巢粒层细胞瘤与纤维卵泡膜细胞瘤蛋白质组学研究

目的:卵巢粒层细胞瘤(ovary granulosa cell tumor,OGCT)与纤维卵泡膜细胞瘤(ovarian fibrothecoma,OF)是卵巢性索间质肿瘤较为常见的类型。由于二者均含有卵泡膜细胞且OGCT呈弥漫性生长模式时与富于细胞的OF和黄素化的OF组织学形态具有相似性,造成二者在病理诊断过程中鉴别困难。本文旨在通过探究OGCT与OF蛋白质组学差异、筛选二者间差异表达蛋白质(differentially expressed proteins,DEPs),发现鉴别诊断二者的生物学标志物。方法:选取5例OGCT和5例OF患者的新鲜肿瘤样本组织,采用蛋白质消化、肽段纯化技术及液相色谱-质谱/质谱分析进行蛋白质定量。运用软件对OGCT和OF的蛋白质进行DEPs分析;对DEPs进行基因本体(gene ontology,GO)和京都基因和基因组数据库(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析,并在生物过程(bioprocess,BP)、分子功能(molecular function,MF)和细胞组分(cell component,CC)方面对蛋白质/基因进行功能注释,探讨DEPs显著富集的信号通路;通过检索基因/蛋白质相互作用(search tool for the retrieval of interacting genes/proteins,STRING)数据库获得筛选出的DEPs相互作用信息,构建蛋白质-蛋白质相互作用(protein-protein interaction,PPI)网络。选取26例OGCT和28例OF石蜡包埋组织,通过组织芯片技术和免疫组织化学染色法验证筛选出的DEPs在OGCT和OF中的表达情况。结果:共筛选出24个OGCT与OF显著DEPs,其中13个蛋白质在OGCT中表达量显著上调,11个蛋白质在OF中表达量显著上调。GO富集分析结果显示:富集到BP上的通路包括细胞外基质(extracellular matrix,ECM)处理过程,细胞外结构组织,有机酸、羧酸、脂肪酸和单羧酸分解代谢过程;富集到CC上的通路包括含胶原蛋白的ECM、内质网腔和线粒体基质;富集到MF上的通路包括硫化物结合、ECM结构成分、酰胺结合、胶原结合、转移酶活性和转移酰基。KEGG富集分析结果显示:上调的DEPs主要富集于缬氨酸、亮氨酸和异亮氨酸降解途径;下调的DEPs主要富集于先天性谷胱甘肽代谢缺陷症、朊病毒疾病、花生四烯酸代谢途径、补体系统、细胞色素P450对异种生物的代谢作用和药物代谢-细胞色素P450。PPI结果显示24个DEPs与多种蛋白质存在相互作用关系。组织芯片免疫组织化学染色显示:PLOD3在OGCT中高表达,在OF中低表达,与富集分析结果一致。结论:通过蛋白质组学技术和生物信息学分析方法共筛选出24个DEPs,经免疫组织化学验证,PLOD3在OGCT与OF鉴别诊断中具有一定的临床应用价值,有望成为OGCT与OF鉴别诊断的生物学标志物。

复发性卵巢颗粒细胞瘤的治疗选择及预后

目的探讨复发性卵巢颗粒细胞瘤(ovarian granulosa cell tumor,OGCT)的临床特征,分析其预后影响因素,评估治疗方案。方法回顾性研究38例复发性OGCT患者的临床特征、复发后治疗方法及生存情况。结果38例复发性OGCT患者的中位复发时间为62.5个月(12~308个月),复发后中位生存时间为33个月(9~106个月)。复发性OGCT患者的1年生存率92%,3年生存率71.9%,5年生存率55.5%。单因素分析显示,复发病灶数目、复发后手术治疗是复发性OGCT患者生存预后的影响因素(P>0.05),多因素生存分析结果显示,复发后手术治疗是复发性OGCT患者生存预后的影响因素(P<0.05)。对27例接受手术治疗的复发性患者单因素分析显示,手术残留病灶是复发性OGCT患者术后再次复发的独立危险因素(P<0.05)。结论复发性OGCT的化疗敏感性较低,手术是复发性OGCT最主要的治疗方法,尽可能完整切除可以降低再次复发风险,提高生存率。

MRI鉴别诊断卵巢颗粒细胞瘤与卵泡膜纤维瘤

目的观察MRI鉴别诊断卵巢颗粒细胞瘤(OGCT)与卵泡膜纤维瘤(OTF)的价值。方法回顾性分析37例OGCT(OGCT组)与74例OTF(OTF组)女性,比较其MRI参数;行多因素logistic回归分析,观察各参数单独及联合鉴别诊断OGCT与OTF的效能。结果组间病灶囊实性分型,囊变程度、囊区最大径,实性部分T2WI信号、强化程度、表观弥散系数(ADC),以及是否合并蜂窝征/奶酪征、有无肿瘤内血管及出血差异均有统计学意义(P均<0.05)。其中,囊变程度、ADC及是否合并蜂窝征/奶酪征为MRI鉴别OGCT与OTF的影响因素,其鉴别OGCT与OTF的曲线下面积(AUC)分别为0.834、0.868及0.744,而三者联合的AUC为0.934,大于其单一AUC(P均<0.05)。结论病灶囊变程度、实性部分ADC及是否合并蜂窝征/奶酪征等MRI特征有助于鉴别OGCT与OTF。

卵巢颗粒细胞瘤的MRI表现及DCE-MRI的定量分析

目的:回顾性分析卵巢颗粒细胞瘤的MRI影像学表现,并初步探究动态对比增强MRI(DCE-MRI)定量分析在卵巢颗粒细胞瘤中的诊断价值。方法:收集本院经病理证实的10例成人型卵巢颗粒细胞瘤患者的临床信息(年龄、肿瘤指标、就诊原因)及MRI影像特征(位置、大小、信号、有无出血、盆腔积液情况),并对图像进行后处理,测量感兴趣区内的表观弥散系数(ADC)值以及DCE-MRI定量参数(Ktrans、Ve、Kep)。结果:10例患者中,70%(7/10)因月经改变、绝经后阴道流血就诊,30%(3/10)因腹痛就诊。其中9例为囊实性病变,T1WI呈等/稍高信号,T2WI呈混杂高信号,实性成分DWI呈高信号,其中6例病灶具有出血征象,7例出现盆腔积液;1例为实性病变,T1WI呈等信号,T2WI呈稍高信号,DWI呈高信号。ADC平均值:实性成分为0.895×10^(-3)mm^(2)/s;囊性成分为2.989×10^(-3)mm^(2)/s。DCE-MRI定量参数Ktrans、Kep、Ve的平均值分别为0.945 min^(-1)、1.912 min^(-1)、0.517。结论:卵巢颗粒细胞瘤好发单侧,主要以囊实性多见,具有“蜂窝状”、“海绵状”特征,病灶多伴出血,因肿瘤体积大,易出现盆腔积液;本研究囊性及实性成分ADC值较以往研究良性肿瘤ADC值低,DCE-MRI定量参数Ktrans、Ve、Kep对卵巢颗粒细胞瘤的定性诊断具有一定价值。

成人型卵巢颗粒细胞瘤的MRI诊断价值及临床分析

目的 探讨成人型卵巢颗粒细胞瘤的MRI表现及其临床特点,提高成人型卵巢颗粒细胞瘤的诊断能力。方法 回顾性分析19例经手术及病理证实的成人型卵巢颗粒细胞瘤的M RI表现及临床资料。结果 19例患者平均年龄为44.4±11.5岁,其中未绝经患者12人,平均年龄为37.6±7.7岁,绝经患者7人,平均年龄为57.3±2.4岁。18位患者有临床症状,以月经不规律及绝经后阴道出血为主。其中11位患者有激素检查结果,72.7%雌激素水平升高,卵泡刺激素水平均下降。MRI上18例为单侧肿块,1例为双侧,多表现为实性肿块内多发囊性灶及出血。T_(1)WI上以低信号为主,80%可见出血灶;T_(2)WI以高信号为主,85%可见“蜂窝征”及“海绵征”。结论 结合成人型卵巢颗粒细胞瘤特征MRI表现和临床特点,对于提高该病的术前诊断具有重要意义。

THE MODIFIED RADIOIMMUNOASSAY OF SERUM INHIBIN AND ITS VALUE IN MONITORING OVARIAN TUMOR

Objectives and Methods: A modified radioimmunoassay (RIA) of serum inhibin (INH) was developed and applied to measure serum INH contents in 39 fertile and 16 postmenopausal women. Thirty-three cases of ovarian tumors, including granulosa cell tumors and other kinds of ovarian tumors, were monitored by serum INH RIA. Results: The mean value of serum INH contents in follicular, peri-ovulatory and mid-luteal phases of fertile women were 9.48±7.10 pg/ml (2.04～18.53pg/ml), 19.04±9.73 pg/ml (3.49～33.26 pg/ml) and 131.13±110.81 pg/ml (3.49～ 341.10 pg/ml), respectively. Serum INH concentration was negatively correlated with serum FSH concentration, (rs=?0.483,P<0.01). Serum IHN contents were less than 3.6 pg/ml in normal postmenopausal women. The mean value of serum INH contents in ovarian granulosa cell tumor, thecoma, mucinous cystadenocarcinoma and malignant teratoma cases were significantly higher than that of other ovarian tumors, (P<0.01). Serum INH contents were elevated in ovarian granulosa cell tumor, thecoma, mucinous cystadenocaricinoma and endometrioid carcinoma cases with serum CA-125 values in normal range before operation, but serum INH contents decreased to normal range within one week after operation. And consecutive serum INH RIA could be a valuable tool in monitoring for therapeutic effect. Conclusion: Modified INH RIA was of convenient, time-saving and quantitative characteristics, especially with its high sensitivity (<1 pg/ml). There was a regular change of serum INH concentrations during menstrual cycle. INH could inhibit the synthesis and secretion of follicle stimulating hormone (FSH). INH would become a valuable marker for ovarian tumor. INH RIA combined with the measurement of serum CA-125 would be helpful to the early diagnosis, treatment and follow-up for ovarian cancer.

A Retrospective Study of Ovarian Sex Cord Stromal Tumors at the Egyptian National Cancer Institute

Background: Ovarian sex cord-stromal tumors are an uncommon heterogeneous group of tumors with different biological behaviors and clinico-patho- logic aspects. Aim of the Work: This study will review the clinico-pathologic aspects of sex-cord stromal ovarian tumors at the National Cancer Institute (NCI), Cairo University, Egypt, as well as their management and follow-up regarding disease free survival and overall survival. Patients and Methods: This retrospective study was conducted at the National Cancer Institute Cairo University, Egypt on female patients with ovarian sex cord stromal tumors in the period from January 2008 to December 2012 with a follow-up period of 24 to 84 months. The age of the patients, different clinical presentations, radiological findings, associated uterine bleeding (need for endometrial biopsy), pre-operative CA125 levels, surgical management done, different histopathological types, different biological behaviors, presence of ascites (and its correlation with the histopathology), Adjuvant chemotherapy (according to biological behavior and pathological type), and follow-up of non-benign cases for up to 84 months will all be documented and studied. Results: The mean age at presentation was 47.34;abdominal pain and mass were the commonest presentations 54.5% and 53.2% respectively;the main radiologic findings were a pelvic mass +/- ascites which had no correlation to the pathological type (p = 0.075). Endometrial hyperplasia and endometrial carcinoma were associated with 22% and 2.5% of cases respectively. Stages I and II represented 95% of patients with non-benign tumors (48 patients). Panhysterectomy +/- infracolic omentectomy or fertility sparing surgery were done in 70.1% and 29.9% of patients respectively. AGCTs were the commonest pathological type (49.4%). Adjuvant chemotherapy was given to 14 patients (46.7%) with non-benign tumors. 6 recurrences (20%) in 30 patients with non-benign tumors on regular follow-up were documented. The median of disease free survival (DFS) was 50.5 months. The median overall survival was 49.5 months. Conclusion: Ovarian SCSTs are uncommon neoplasms with different biological behaviors where AGCTs are the commonest among Egyptian females. Hormonal manifestations are uncommon where abnormal vaginal bleeding is the commonest one. The presence of ascitic fluid has no correlation with the pathological type of the tumor. Early stages (I and II) represented about 95% of non-benign tumors. Surgical management without lymphadenectomy +/- adjuvant chemotherapy is the main line of treatment at our institute. The OS was shorter than that documented in the literature. A small number of patients, reluctance of follow-up and unavailability of some patients’ data were the main drawbacks in this study.

Ovarian Sex Cord-Stromal Tumors in Postmenopausal Women and Total Laparoscopical Management

BACKGROUND: Ovarian sex-cord stromal tumors (SCST) take up 5% of the ovarian neoplasm and may develop in?to?an ovarian mass or a haemoperitoneum. The surgical management of SCST in early-stage adult patients is not well?defined. CASE REPORT: A 69 year-old postmenopausal woman was admitted for metrorrhagia, a right ovary mass and?increasing pelvic pain. Preoperative clinical and instrumental examination suspected an ovarian tumor, and the?laparoscopic right ophorectomy and the frozen section suggested an ovarian SCST. To fast restore and preserve woman?integrity, total laparoscopic hysterectomy (TLH) plus left salpingo-ophorectomy (SO) were performed, without complications?in the short and long term follow-up. CONCLUSION: In the authors’ opinion, the minimally invasive management?of SCST by TLH plus bilateral SO followed by a prolonged surveillance and without intensive surgical staging,?could be an appropriate clinical and surgical choice in elder patient at early stage, since these tumors are slow at?growth, recurring locally and only a long time after initial treatment. We suggest, after a minimally invasive treatment,?a possible “wait and see” option, as in our case report.