卵巢间质黄体瘤一例报告并文献复习

卵巢类固醇细胞瘤是一种少见的卵巢肿瘤,约占卵巢肿瘤≤0.1%,根据其肿瘤组织的来源分为间质黄体瘤、Leydig细胞瘤、非特异性类固醇细胞瘤3类。卵巢间质黄体瘤是临床少见疾病,其无特异性表现,彩色超声和影像学检查不易查出,容易造成术前误诊、漏诊。本文回顾性分析我院收治的卵巢间质黄体瘤临床资料并进行相关文献复习,卵巢间质黄体瘤的确诊需结合临床表现及术后病理,手术是其主要治疗方法。     

卵巢类固醇细胞瘤1例报道

<正>卵巢类固醇瘤发生率很低,大约仅占卵巢肿瘤的1%,但病理非常复杂,目前临床上主要将该类肿瘤分为三种类型:间质黄体瘤、非特异性类固醇细胞瘤、睾丸型间质细胞瘤[1]。临床表明,了解卵巢类固醇瘤的临床特点并积极进行治疗对于保障患者的生命安全具有非常重要的意义。选取我院2014年收治的1例类固醇细胞瘤患者,采取手术治疗,疗效显著,报告如下。1临床资料患者,女,19岁,未婚,无性生活史,主因"发现盆     

卵巢类固醇细胞瘤一例报告

卵巢类固醇细胞瘤是较为罕见的卵巢肿瘤,大多为良性肿瘤,但也存在向恶性转化风险,可产生类固醇激素,特别是雄激素。影像学表现缺乏特异性,诊断依据组织病理学及免疫组织化学标记物,手术切除是主要的治疗方法,但近年来也开始尝试使用促性腺激素释放激素类似物治疗此类疾病。回顾性分析吉林大学第二医院收治的1例非特异性卵巢类固醇细胞瘤患者的诊治过程,并结合相关文献对该疾病进行分析。探讨卵巢类固醇细胞瘤的临床诊断和治疗进展,分析其临床特点,以提高对该疾病的诊治水平。     

卵巢类固醇细胞瘤一例报告

卵巢类固醇细胞瘤是较为罕见的卵巢肿瘤,大多为良性肿瘤,但也存在向恶性转化风险,可产生类固醇激素,特别是雄激素。影像学表现缺乏特异性,诊断依据组织病理学及免疫组织化学标记物,手术切除是主要的治疗方法,但近年来也开始尝试使用促性腺激素释放激素类似物治疗此类疾病。回顾性分析吉林大学第二医院收治的1例非特异性卵巢类固醇细胞瘤患者的诊治过程,并结合相关文献对该疾病进行分析。探讨卵巢类固醇细胞瘤的临床诊断和治疗进展,分析其临床特点,以提高对该疾病的诊治水平。     

卵巢非特异性类固醇细胞瘤2例分析及文献复习

目的：探讨卵巢非特异性类固醇细胞瘤的临床、病理学特点,以及诊断和治疗方法。方法：回顾性分析复旦大学附属妇产科医院2000—2010年间收治的2例卵巢非特异性类固醇细胞瘤患者的临床资料,并进行文献复习。结果：良、恶性卵巢非特异性类固醇细胞瘤各1例。2例患者均表现为闭经、男性化等特征,术中及病理所见均与已报道特点一致。良性患者经保守治疗后各项生化指标恢复正常,随访至今状况良好;而恶性患者虽经手术和化疗,10个月后仍死于肿瘤复发。结论：卵巢非特异性类固醇细胞瘤是罕见的卵巢肿瘤,治疗以手术为主,部分患者为恶性,可行化疗,但预后较差。     

卵巢肿瘤与高雄激素血症

卵巢肿瘤合并高雄激素可使患者出现男性化表现,如闭经、不孕、痤疮等,影响患者外观及生活。产生雄激素的卵巢肿瘤最常见的是性索间质肿瘤向男性分化形成的支持-间质细胞肿瘤,其次是卵巢非特异型类固醇细胞瘤。卵巢黏液性囊腺瘤、库肯勃氏瘤、某些生殖细胞肿瘤如成熟畸胎瘤等组织类型也可引起雄激素增加,卵巢透明细胞癌产生雄激素非常罕见。本文就合并高雄激素血症的卵巢肿瘤做一综述。     

卵巢良性病变的保守性手术

卵巢良性病变是妇科常见病,它包括卵巢瘤样病变及卵巢良性肿瘤。卵巢瘤样病变其发病原因涉及生理及病理两方面,常见的如卵泡囊肿、黄体囊肿、卵巢内膜样囊肿、多囊卵巢等,有时卵巢瘤样病变还涉及卵巢功能,在临床上常和真性卵巢肿瘤混淆。卵巢肿瘤种类繁多,组织结构复...     

卵巢无性细胞瘤伴少量合体滋养叶细胞和腺样卵黄囊细胞一例及文献复习

无性细胞瘤（dysgerminoma）是卵巢比较少见的肿瘤,占原发卵巢肿瘤的1％,其中3％～5％出现合体滋养叶细胞分化,少部分出现卵黄囊成分。腺型卵黄囊是卵黄囊瘤中比较少见的形态,易引起误诊。在此报道一例卵巢无性细胞瘤伴少量合体滋养叶细胞及腺样卵黄囊细胞,并结合文献分析其临床病理特征。     

卵巢晚期或复发性颗粒细胞瘤患者的放射治疗

卵巢性索间质肿瘤发病率占所有卵巢恶性肿瘤的不足5%,而卵巢颗粒细胞瘤更是少见,治疗也不规范。特别是对初次手术后有较大残瘤病灶或肿瘤复发的理想治疗方案尚不确切。本文回顾性分析1949～1988年在MDAnderson癌症中心确诊并接受放疗的34例卵巢颗烂细胞瘤患者临床资料,以?..     

青春期巨大原发性卵巢平滑肌瘤1例报告

正原发性卵巢平滑肌瘤(primary leiomyoma ofovary,PLO)是非特异性良性间质卵巢肿瘤,20~65岁均可发病,绝经期和绝经后妇女多见,多单侧。临床罕见,组织来源及临床特点不清,易误诊,青春期巨大卵巢平滑肌瘤更为少见。现将中山市博爱医院1例青春期巨大原发性卵巢平滑肌瘤报道如下。1病历摘要患者12岁11个月。因"体检发现盆腔包块5 d"于2016-04-11入广东省中山市博爱医院。乳房发     

Ovarian stromal luteoma in a patient with endometrial carcinoma

A 65-year-old patient with endometrial adenocarcinoma underwent hysterectomy. Pathological examination of the right ovary revealed a coexisting stromal luteoma. The possible relationship between the two neoplasms as well as the intriguing pathogenesis and controversial nomenclature of ovarian steroid cell tumors are discussed. The incidental discovery of a stromal luteoma in a total hysterectomy specimen removed for endometrial carcinoma raises interesting questions about the perceived innocuous nature of these rare lipid cell tumors.     

An ovarian steroid cell tumor with virilization and hypothyroidism: a case report

Steroid cell tumors are rare ovarian sex-cord stromal tumors with malignant potential. The majority of these tumors produce steroids with testosterone being the most common. The diagnosis of these rare tumors can be problematic especially in the case of a small nonpalpable ovarian tumor. A 41-year-old woman presented with the gradual onset of defeminization, mild hypothyroidism, and virilization. A physical examination revealed a relatively healthy woman with borderline hirsutism, clitoromegaly and adnexal fullness without a palpable tumor. Elevated serum levels of TSH and testosterone were found preoperatively. Five weeks after an oophorectomy, serum levels of TSH and testosterone returned to normal and menstruation returned. Nonpalpable virilizing ovarian steroid cell tumors may be difficult to diagnose. A careful study of the patient’s history, the development of defeminization followed by virilization, and a “characteristic” ultrasonogram, can be helpful for diagnosis. Hormonal studies including thyroid function should also be considered in an ovarian steroid cell tumor.     

Luteoma estromal ovárico como causa de virilización en la mujer posmenopáusica

Objective

We report the case of a patient diagnosed with a stromal luteoma of the ovary with a virilizing effect.

Material and methods

A 67-year-old woman presented with symptoms of virilization. Although no androgen-producing tumor was detected on imaging tests, the patient underwent hysterectomy and double oophorectomy due to strong clinical and laboratory suspicion of an androgen-producing tumor of the ovary.

Results

Pathologic study of the surgical specimen showed the presence of an ovarian stromal luteoma causing the patient's virilization.

Conclusions

Ovarian stromal luteoma is a rare ovarian neoplasm that usually occurs in postmenopausal women and may present as virilization or hyperestrogenism. In 20% of cases, the diagnosis is incidental.     

Ovarian Sex Cord Stromal Tumor,Steroid Cell,NOS in an Adolescent: A Case Report

BackgroundOvarian steroid cell tumor, not otherwise specified (NOS), is a rare type of sex cord stromal tumor, which often presents with androgenic symptoms and has a high frequency of malignancy.CaseThis is a case of a 14-year-old Native American girl who presented with acne, amenorrhea, and virilization and was found to have a 2.9-cm solid ovarian mass. Initial pathology revealed steroid-appearing cells with round nuclei, clear/vacuolated cytoplasm, and a low mitotic index. Final diagnosis was ovarian steroid cell tumor, NOS Stage IA. A laparoscopic left salpingo-oophorectomy was subsequently performed. No tumor recurrence was noted 2 years after her initial diagnosis.Summary and ConclusionLong-term data on these tumors are limited; however, malignancy, recurrence, and death have been reported. This suggests that close follow-up is essential for appropriate management.     

Postmenopausal hyperandrogenism of ovarian origin. A clinicopathologic study of four cases.

Postmenopausal hyperandrogenism with overt clinical effects is rare and often related to ovarian stromal disorders. We present a clinicopathologic study of 4 cases. The patients (age range 41-75 years; mean 62 years) had evidence of hirsutism or frank virilization. Their serum testosterone was elevated with or without increases in their serum androstenedione and DHEA levels. There were two right-ovarian hilus cell tumors, one associated with left-ovarian stromal hyperplasia and the other with bilateral hyperthecosis and nodular hilus cell hyperplasia. The other tumor was a small corticomedullary stromal luteoma with bilateral hyperthecosis and nodular hilus cell hyperplasia. The fourth patient had bilateral hilus cell hyperplasia with mild cortical-stromal hyperplasia. All these patients had rapid normalization of androgen levels after surgery without recurrence after a 2- to 10-year follow-up.     

卵巢肿瘤2 668例分类及发病特点分析

目的了解卵巢肿瘤发病特点及其发病规律，为医疗决策提供依据。方法回顾性描述1951年-2000年我院收治的2668例卵巢肿瘤发病情况。结果各型卵巢肿瘤例数随年代进展逐年增加，各年代以表面上皮一间质肿瘤和生殖细胞肿瘤最多，两者构成比之和均达到85％以上，其次为性索间质肿瘤、继发性肿瘤等；不同发病年龄组各类卵巢肿瘤构成比仍以表面上皮一间质肿瘤和生殖细胞肿瘤最多，两者构成比之和均达到77％以上，其中恶性肿瘤以41～60岁发病年龄组较多，交界瘤以21～50岁发病年龄组较多。结论鉴于各类卵巢肿瘤发病人数日趋升高，临床应对其引起高度重视；各类卵巢肿瘤具有不同的发病年龄特征，为正确诊治提供参考。     

CD56 is a sensitive and diagnostically useful immunohistochemical marker of ovarian sex cord-stromal tumors.

Ovarian sex cord-stromal tumors comprise a heterogeneous group of neoplasms with wide morphological diversity, and they can be mistaken for a variety of other tumors. Some types, including granulosa and Sertoli cell tumor, may be confused with a neuroendocrine neoplasm. CD56 is a widely used neuroendocrine marker with a high sensitivity for neuroendocrine tumors and is commonly used as part of a panel to distinguish between a neuroendocrine neoplasm and other tumors in the differential diagnosis. In this study, we investigate CD56 staining in ovarian sex cord-stromal tumors. CD56 staining has not previously been studied in this group of neoplasms. We stained a large series of ovarian sex cord-stromal neoplasms (n = 85) with CD56. Neoplasms studied were adult granulosa cell tumor (n = 40), juvenile granulosa cell tumor (n = 8), Sertoli cell tumor (n = 1), Sertoli-Leydig cell tumor (n = 14), Leydig cell tumor (n = 2), steroid cell tumor, not otherwise specified (n = 2), sclerosing stromal tumor (n = 1), sex cord tumor with annular tubules (n = 2), and fibroma (n = 15). Three uterine tumors resembling ovarian sex cord tumor were also studied. Nonneoplastic ovaries, including 3 cases of pregnancy-related granulosa or Sertoli cell proliferation, were also included. In nontumorous ovaries, granulosa cells of follicular and corpus luteum cysts were consistently negative. The normal ovarian stroma was diffusely positive, as were the 3 pregnancy-related proliferations. All sex cord-stromal tumors except one were positive with CD56; staining ranged from focal to diffuse but was usually diffuse involving more than 50% of tumor cells. Staining was usually membranous with weaker cytoplasmic positivity. CD56 immunoreactivity is almost universal in ovarian sex cord-stromal tumors of all the major morphological types and is of no value in distinguishing a sex cord-stromal and a neuroendocrine neoplasm. Since CD56 is an extremely sensitive marker of ovarian sex cord-stromal tumors, it may be useful in the diagnosis of this group of neoplasms, especially in cases which are alpha inhibin or calretinin negative, and in distinguishing these from mimics which are CD56 negative.     

Sclerosing stromal tumor of the ovary associated with Meigs' syndrome: a case report

Sclerosing stromal tumors of the ovary are distinct, but rare benign neoplasms. These tumors appear solid and are very vascular giving the impression of malignant tumors. They occur mostly in young women. Morphologically they have distinct characteristics which differentiate them from other stromal tumors. Benign ovarian tumors associated with Meigs' syndrome are rare. In this article a case of ovarian sclerosing stromal tumor associated with Meigs' syndrome in a 17-year-old women is described and the differential diagnosis is also discussed.     

Inhibin alpha and beta expression in ovarian stromal tumors and their histological equivalences

Inhibin is a heterodimeric protein hormone that appears to be a sensitive immunohistochemical marker of sex cord-stromal tumors. Although sex cord-stromal tumors can usually be distinguished from ovarian epithelial tumors or their metastases by morphology or by using antibodies against intermediate filaments, the diagnosis remains difficult in rare situations in such cases as sarcomatoid granulosa-theca cell tumors, ovarian small cell carcinomas, or soft-tissue sarcomas. The purposes of this study were to examine inhibin alpha and beta immunoreactivity in a wide range of gonadal stromal neoplasms and to assess its value in the differential diagnosis of problematic tumors. A total of 108 paraffin-embedded ovarian and extraovarian tumors were examined immunohistochemically by using anti-alpha inhibin and anti-beta inhibin. Inhibin alpha immunostaining was identified in 46 (81%) of 57 gonadal stromal tumors, one (14%) of seven endometrial stromal tumors, and one (50%) of two primary ovarian carcinoid tumors. Inhibin beta immunostaining was detected in 55 (96%) of 57 gonadal stromal tumors, two (29%) of seven endometrial stromal tumors, one (50%) of two dysgerminomas, and in all of two (100%) primary ovarian carcinoid tumors. Inhibin alpha expression was not detected in any ovarian surface epithelial tumor cells. Some surface epithelial tumors showed stromal inhibin alpha (15% of cases) and inhibin beta (48% of cases) positivity. Weak immunoreactivity for inhibin beta was found in most (83% of cases) ovarian surface epithelial tumors. Two ovarian Burkitt lymphomas were negative for inhibin alpha and beta. Inhibin alpha is a sensitive immunohistochemical marker of gonadal stromal tumors and is of value in the differential diagnosis of ovarian neoplasia. Inhibin beta is a nonspecific marker for ovarian neoplasms, showing expression on tumor and stromal cells of different epithelial or stromal tumors.