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 we...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.展开更多
BACKGROUND Ovarian endometrioid carcinoma resembling sex cord-stromal tumor(ECSCSs)is rare.CASE SUMMARY We present a rare case of primary ECSCSs in the left ovary.A 39-year-old female patient had persistent dull pain ...BACKGROUND Ovarian endometrioid carcinoma resembling sex cord-stromal tumor(ECSCSs)is rare.CASE SUMMARY We present a rare case of primary ECSCSs in the left ovary.A 39-year-old female patient had persistent dull pain in the lower abdomen for more than 1 mo,and she was initially diagnosed with pelvic inflammatory disease at a hospital.The patient received transabdominal hysterectomy,bilateral salpingo-oophorectomy,and pelvic and para-aortic lymph node dissection at our hospital and finally diagnosed with ECSCSs.After the operation,the patient received eight courses of cisplatinum+etoposide+bleomycin chemotherapy treatment and no evidence of tumor recurrence or metastasis was found in a 2-year follow-up period.CONCLUSION Ovarian endometrioid carcinoma is similar to the ovary sex cord-stromal tumor,especially when the cord-like structure is obvious.The clinical diagnosis for this tumor is difficult before surgery and pathology examination.The necessary immunohistochemical markers are of positive significance for assisting diagnosis and differential diagnosis.展开更多
BACKGROUND Endometrial stromal tumors originate from the endometrial stroma and account for<2%of all uterine tumors.Uterine tumor resembling an ovarian sex cord tumor(UTROSCT)is a rare histological class of endomet...BACKGROUND Endometrial stromal tumors originate from the endometrial stroma and account for<2%of all uterine tumors.Uterine tumor resembling an ovarian sex cord tumor(UTROSCT)is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors.Here,we report a case of UTROSCT in a 51-year-old woman.CASE SUMMARY A 51-year-old woman had irregular menses for 6 mo.The patient visited a local hospital for vaginal bleeding.Pelvic computed tomography(CT)showed a mass in the pelvic cavity.Five days later,she came to our hospital for further diagnosis.The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor.She then underwent total removal of the uterus with bilateral salpingectomy.Postoperative histological examination showed that the tumor cells had abundant cytoplasm,ovoid and spindle-shaped nuclei,fine chromatin,a high nucleoplasm ratio,and a lamellar distribution.The findings were consistent with UTROSCT,and the results of immunohistochemical analysis supported that diagnosis.The tumor was International Federation of Gynecology and Obstetrics stage IB.No adjuvant therapy was administered after radical surgery.The patient was followed up for 58 mo,and no recurrence was found.CONCLUSION We report a case of UTROSCT with abnormal menstruation as a symptom,which is one of the most common symptoms.In patients with vaginal bleeding,ultrasonography can be used as a screening test because of its convenience,speed,and lack of radiation exposure.For patients with long-term tamoxifen use,routine monitoring of the endometrium is recommended.As UTROSCT may have low malignant potential,surgery remains the primary management strategy.Additionally,fertility preservation in patients of childbearing age is a vital consideration.展开更多
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-patho...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.展开更多
BACKGROUND Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of theovary. It was first reported and named in 1973. These tumors typically presentwith pelvic/abdominal pain and tenderness, a ma...BACKGROUND Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of theovary. It was first reported and named in 1973. These tumors typically presentwith pelvic/abdominal pain and tenderness, a mass, and/or abnormal menses,but rarely present with masculinity in children and adolescents. Only 2 cases ofthese tumors have been reported in premenarchal girls, who demonstratedhormonal activity, with a history of the development of a virilizing female due tohyperandrogenism. Here, we report a case of a giant SST with obviousmasculinity combined with Meig’s syndrome and CA125 elevation.CASE SUMMARY A 17-year-old female presented with a 7-year history of the development ofmasculinity and a 2-year history of amenorrhea. She had hirsutism, acne, obviouslaryngeal prominence, and voice deepening. Physical examination showed a malesuprapubic hair pattern and a 4.0 cm × 1.5 cm enlarged clitoris. Laboratory testsshowed that the testosterone level was > 15.00 ng/mL (normal range: 0.14-0.76ng/mL), and androstenedione level was > 10.00 ng/mL (normal range: 0.3-3.3ng/mL). A computed tomography scan of the abdomen and pelvis was carriedout and showed a large, solid and cystic, partly calcified pelvic mass in the rightovary measuring 27.1 cm × 20.0 cm × 11.0 cm, 15 cm above the umbilicus (to thelevel of the upper part of L1). Intraoperative findings at laparotomy revealed alarge tumor arising from the right ovary. Approximately, 500 mL of pale-yellow clear liquid was found in the pelvic cavity. A right salpingo-oophorectomy wasperformed. Microscopic examination and immunohistochemical staining of thesurgical specimen showed an SST of the ovary.CONCLUSION This report is remarkable as our patient was not only diagnosed with an SST ofthe ovary, which is extremely rare in this age group, but was the largest and mostobvious reported patient with this tumor who presented with virilization.Therefore, gynecologists should be aware of this potential complication inadolescent girls with a mass in the ovary.展开更多
Sertoli-Leydig cell tumor of the ovary is a kind of sex cord-stromal tumor, which occurs between teens and twenties with symptoms including abdominal pain and swelling. The incidence rate is infinitely rare comprising...Sertoli-Leydig cell tumor of the ovary is a kind of sex cord-stromal tumor, which occurs between teens and twenties with symptoms including abdominal pain and swelling. The incidence rate is infinitely rare comprising less than 0.5% of all ovarian tumor. The average age of “retiform Sertoli-Leydig cell tumor” is 17 years as compared to 25 years for Sertoli-Leydig cell tumors as a group. We have experienced this rare case of retiform Sertoli-Leydig cell tumor in a 25-year-old foreign patient with the complaint of palpable mass on the right lower quadrant and an irregular menstrual period. The patient underwent right salpingo-oophorectomy and tumor stage was FIGO stage 1A. We report with a brief review of literature.展开更多
文摘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.
文摘BACKGROUND Ovarian endometrioid carcinoma resembling sex cord-stromal tumor(ECSCSs)is rare.CASE SUMMARY We present a rare case of primary ECSCSs in the left ovary.A 39-year-old female patient had persistent dull pain in the lower abdomen for more than 1 mo,and she was initially diagnosed with pelvic inflammatory disease at a hospital.The patient received transabdominal hysterectomy,bilateral salpingo-oophorectomy,and pelvic and para-aortic lymph node dissection at our hospital and finally diagnosed with ECSCSs.After the operation,the patient received eight courses of cisplatinum+etoposide+bleomycin chemotherapy treatment and no evidence of tumor recurrence or metastasis was found in a 2-year follow-up period.CONCLUSION Ovarian endometrioid carcinoma is similar to the ovary sex cord-stromal tumor,especially when the cord-like structure is obvious.The clinical diagnosis for this tumor is difficult before surgery and pathology examination.The necessary immunohistochemical markers are of positive significance for assisting diagnosis and differential diagnosis.
文摘BACKGROUND Endometrial stromal tumors originate from the endometrial stroma and account for<2%of all uterine tumors.Uterine tumor resembling an ovarian sex cord tumor(UTROSCT)is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors.Here,we report a case of UTROSCT in a 51-year-old woman.CASE SUMMARY A 51-year-old woman had irregular menses for 6 mo.The patient visited a local hospital for vaginal bleeding.Pelvic computed tomography(CT)showed a mass in the pelvic cavity.Five days later,she came to our hospital for further diagnosis.The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor.She then underwent total removal of the uterus with bilateral salpingectomy.Postoperative histological examination showed that the tumor cells had abundant cytoplasm,ovoid and spindle-shaped nuclei,fine chromatin,a high nucleoplasm ratio,and a lamellar distribution.The findings were consistent with UTROSCT,and the results of immunohistochemical analysis supported that diagnosis.The tumor was International Federation of Gynecology and Obstetrics stage IB.No adjuvant therapy was administered after radical surgery.The patient was followed up for 58 mo,and no recurrence was found.CONCLUSION We report a case of UTROSCT with abnormal menstruation as a symptom,which is one of the most common symptoms.In patients with vaginal bleeding,ultrasonography can be used as a screening test because of its convenience,speed,and lack of radiation exposure.For patients with long-term tamoxifen use,routine monitoring of the endometrium is recommended.As UTROSCT may have low malignant potential,surgery remains the primary management strategy.Additionally,fertility preservation in patients of childbearing age is a vital consideration.
文摘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.
文摘BACKGROUND Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of theovary. It was first reported and named in 1973. These tumors typically presentwith pelvic/abdominal pain and tenderness, a mass, and/or abnormal menses,but rarely present with masculinity in children and adolescents. Only 2 cases ofthese tumors have been reported in premenarchal girls, who demonstratedhormonal activity, with a history of the development of a virilizing female due tohyperandrogenism. Here, we report a case of a giant SST with obviousmasculinity combined with Meig’s syndrome and CA125 elevation.CASE SUMMARY A 17-year-old female presented with a 7-year history of the development ofmasculinity and a 2-year history of amenorrhea. She had hirsutism, acne, obviouslaryngeal prominence, and voice deepening. Physical examination showed a malesuprapubic hair pattern and a 4.0 cm × 1.5 cm enlarged clitoris. Laboratory testsshowed that the testosterone level was > 15.00 ng/mL (normal range: 0.14-0.76ng/mL), and androstenedione level was > 10.00 ng/mL (normal range: 0.3-3.3ng/mL). A computed tomography scan of the abdomen and pelvis was carriedout and showed a large, solid and cystic, partly calcified pelvic mass in the rightovary measuring 27.1 cm × 20.0 cm × 11.0 cm, 15 cm above the umbilicus (to thelevel of the upper part of L1). Intraoperative findings at laparotomy revealed alarge tumor arising from the right ovary. Approximately, 500 mL of pale-yellow clear liquid was found in the pelvic cavity. A right salpingo-oophorectomy wasperformed. Microscopic examination and immunohistochemical staining of thesurgical specimen showed an SST of the ovary.CONCLUSION This report is remarkable as our patient was not only diagnosed with an SST ofthe ovary, which is extremely rare in this age group, but was the largest and mostobvious reported patient with this tumor who presented with virilization.Therefore, gynecologists should be aware of this potential complication inadolescent girls with a mass in the ovary.
文摘Sertoli-Leydig cell tumor of the ovary is a kind of sex cord-stromal tumor, which occurs between teens and twenties with symptoms including abdominal pain and swelling. The incidence rate is infinitely rare comprising less than 0.5% of all ovarian tumor. The average age of “retiform Sertoli-Leydig cell tumor” is 17 years as compared to 25 years for Sertoli-Leydig cell tumors as a group. We have experienced this rare case of retiform Sertoli-Leydig cell tumor in a 25-year-old foreign patient with the complaint of palpable mass on the right lower quadrant and an irregular menstrual period. The patient underwent right salpingo-oophorectomy and tumor stage was FIGO stage 1A. We report with a brief review of literature.
