Well Differentiated Combined Sertoli-Leydig Cell Tumour of the Ovary

Summary: A virilising ovarian neoplasm in a 31-year-old woman proved to be a well differentiated combined Sertoli-Leydig cell tumour. The case is of interest, not only because of its rarity, but also because it illustrates a characteristic clinico-pathological correlation, which is supported by electron microscopic and clinical hormonal studies.     

Macrofolliculoid Granulosa Cell Tumour Mistaken for a Polycystic Ovary at Ultrasound Scan

EDITORIAL COMMENT: We accepted this case for publication because it carries the important clinical message that an oestrogen-producing tumour should be considered in patients with anovulation especially when the classical features of polycystic ovarian disease are not present and when the alleged polycystic ovary was defined to be present on one side only. In these patients an oestrogen assay by showing markedly elevated levels is a useful screening test for oestrogen secreting tumours of the ovary or adrenal gland.     

Juvenile Granulosa and Theca Cell Tumor of the Ovary as a Rare Cause of Precocious Puberty: Case Report and Review of Literature

BackgroundThe differential diagnosis for precocious puberty in a young female includes peripheral causes. This case documents a rare cause of peripheral precocious puberty—a juvenile granulosa and theca cell ovarian tumor—and a brief review of the literature for this tumor type.CaseA 7-year-old girl presented with rapid onset of pubertal development and elevated estradiol levels. Menarche occurred 5 months after thelarche. A thorough workup revealed a large multicystic left ovary. Other causes of precocious puberty were excluded. She underwent an exploratory laparotomy and left salpingo-oophorectomy. Pathology reported a juvenile granulosa and theca cell tumor of the ovary, FIGO stage 1A. Postoperatively, she experienced a cessation of vaginal bleeding and estradiol levels normalized. A literature review found that early stage disease has an excellent prognosis and that adjuvant chemotherapy is not indicated in this setting.Summary and ConclusionJuvenile granulosa and theca cell tumor of the ovary is a rare cause of peripheral precocious puberty, even more so than juvenile granulosa cell tumor, due to the theca component. Treatment is surgical and an excellent prognosis is possible for early stage disease.     

Pulmonary Pseudotumours Following Chemotherapy for Endodermal Sinus Tumour of the Ovary

Summary: We report a case of a 20-year-old woman with an endodermal sinus tumour of the ovary which showed tumour marker evidence of relapse after unilateral oophorectomy. Tumour markers returned to normal after chemotherapy, but the development of pulmonary opacities led to exploratory thoracotomy which revealed an organized nodular lymphoid aggregate in the lung showing active sclerosing interstitial pneumonitis. The patient remains well without tumour relapse 28 months after oophorectomy.     

Composite Mucinous and Granulosa-Theca-Cell Tumour of the Ovary: An Unusual Neoplasm

Summary: This case represents a unique primary ovarian tumour consisting of malignant mucinous elements and granulosa-theca-cell elements, the histogenesis of which remains uncertain. It also underscores the need for thorough sampling of mucinous tumours in order to discover a possible coexisting, different neoplastic component.     

Late Relapse of Ovarian Germ Cell Tumour

Background

Malignant ovarian germ cell tumours typically require multimodal therapy including surgery and systemic platinum-based chemotherapy. Most patients are cured, with survival rates exceeding 95%.

Clinical Review of Adult Granulosa Cell Tumors of the Ovary

Granulosa cell tumors are uncommon neoplasms that are characterized by their long natural history and for their tendency to recur years after an apparent clinical cure. As such they are difficult tumors to study. In the majority of cases, the initial therapy is surgical although the extent of the necessary procedure remains controversial. The role for any adjuvant therapy after complete resection remains to be established. In patients with advanced disease, combination chemotherapy consisting of cisplatinum/vinblastine/bleomycin has the highest identified response rates. In patients with recurrent or metastatic disease therapy is palliative and has not yet been standardized. Treatments therefore need to be individualized.     

Endodermal Sinus Tumour of the Ovary: The Place of Alphafetoprotein Detection, Surgery and Chemotherapy

New developments in the management of the rare endodermal sinus tumour of the ovary, together with the reporting of 2 additional patients, are presented. There is a need for accurate clinical and pathological evaluation of the disease. As shown in the present study, histochemical staining for alphafetoprotein (AFP) provides an additional factor in diagnosis, and monitoring of AFP levels in serum is a useful guide to treatment. The prognosis, previously uniformly poor, appears to be improved with the use of multidrug chemotherapy. In a collated series of 98 patients, the 24-month survival rate was 65% in Stage I disease and 67% in Stage II disease. However, the choice of effective drugs remains uncertain. The improved survival of young patients with aggressive chemotherapy has now raised the question of preservation of fertility at the time of surgery. In a small collated series of 26 patients with Stage I disease, survival to 36 months was not jeopardized by the conservative removal of one tube and ovary.     

Theca cell tumor of the ovary

A definite case of a ruptured theca cell tumor of the ovary occurring in a young woman and characterized by a prolonged amenorrhea is hereby reported. With oophorectomy, there was a complete regression of symptoms. It is our hope to report, at a later date, the results of a biochemical assay of this tissue.     

Malignant Stromal Tumour of the Ovary with Virilizing Effects in an XXX Female with Streak Ovaries

Summary: In gonadal dysgenesis, the presence of the Y sex chromosome appears to have a strong influence on the development of germ cell tumours. The risk of malignancy associated with other sex chromosomal abnormalities is much lower. In the present report, the clinical manifestations – including primary amenorrhoea, tall stature, infertility and poor development of the genitalia and breasts – associated with a predominantly 47, XXX karyotype are described. Malignant change of the streak ovary to an unusual gonadal stromal tumour with lipid-containing cells occurred at a late stage in her life, and this was associated with progressive virilization and production of androgenic and oestrogenic steroids. In view of the risk of malignancy as well as the abnormal endocrine effects, especially in the presence of a Y chromosome, there is a place for the prophylactic removal of these dysgenetic gonads.     

C－erbB3在卵巢移行细胞癌组织中的过度表达

采用单克隆抗体免疫组化技术对２０例正常卵巢和３２例卵巢移行细胞癌组织进行Ｃ－ｅｒｂ－Ｂ３癌基因产物表达的检测。比较正常卵巢与卵巢移行细胞癌组织Ｃ－ｅｒｂＢ３表达的异同，分析卵巢移行细胞癌组织Ｃ－ｅｒｂＢ３过度表达与预后诸因素间的关系。结果：正常卵巢组织Ｃ－ｅｒｂＢ３的表达率为３０％，卵巢移行细胞癌Ｃ－ｅｒｂＢ３的表达率为４７％（Ｐ＞０．０５）。卵巢移行细胞癌Ｃ－ｅｒｂＢ３过度表达与患者的年龄、临床分期、ＣＡ＿（１２５）水平、组织学分化和淋巴结转移间未见明显关系（Ｐ＞０．０５），但是，Ｃ－ｅｒｂＢ３过度表达的卵巢移行细胞癌患者的预后较差。     

Squamous Cell Carcinoma Arising in Mature Cystic Teratoma of the Ovary

Treatment results of 26 patients with squamous cell carcinoma (SCC) arising in mature cystic teratoma of the ovary were analyzed. Four nulliparous patients with stage Ia tumors underwent conservative salpingo-oophorectomy. Following surgery, 2 patients had successful pregnancies. The remaining 7 patients with stage Ia tumors were observed after hysterectomy and bilateral salpingo-oophorectomy. Fifteen patients with stage Ic–IV tumors underwent cytoreductive surgery followed bycis-platinum-based chemotherapy with or without sequential radiotherapy. The mean survival was 63.9 months. The overall actuarial disease-free survival at 2 years was 69%, and by stage was as follows: stage I, 100% (13/13); stage II, 100% (2/2); stage III, 30% (3/10); and stage IV, 0% (0/1). A significant difference in disease-free survival was noted in stage (P= 0.0001). Optimal versus suboptimal operation was associated with a median Kaplan–Meier survival of 65 months versus 34.8 months, with actuarial disease-free survival at 2 years of 60 and 0%, respectively (P= 0.0210). Our study shows that 67% (16/24) of the patients had SCC antigen levels exceeding 2 ng/ml, which by stage was as follows: stage I, 5/11 (45%); stage II, 1/2 (50%); stage III, 9/10 (90%); and stage IV, 1/1 (100%). After completion of treatment, all 8 patients with recurrent lesions had reelevated SCC antigen levels in series SCC antigen monitoring. In conclusion, positive prognostic factors of disease-free survival were optimal cytoreduction and lower FIGO stage. We suggest that multimodality therapy, including aggressive cytoreduction followed bycis-platinum-based chemotherapy with or without sequential radiotherapy, is recommended. In addition, we suggest that serum SCC antigen monitoring may be helpful in early detection of cancer recurrence.