Post-menopausal ovarian fibroma associated with steroid hormone synthesis: A case report |
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| Affiliation: | 1. Iwate Prefectural Central Hospital, Department of Pathology, Morioka, Iwate, Japan;2. Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan;3. Japanese Red Cross Ishinomaki Hospital, Department of Pathology, Ishinomaki, Miyagi, Japan;4. Japanese Red Cross Ishinomaki Hospital, Department of Gynecology, Ishinomaki, Miyagi, Japan;5. Sendai Kousei Hospital, Department of Pathology, Sendai, Miyagi, Japan;6. Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan |
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| Abstract: | ObjectiveOvarian fibromas are benign, sex cord-stromal tumors occurring in both peri- and post-menopausal women. Generally, these tumors are non-functional and do not produce hormones. However, this case report proves the first case of steroid hormone synthesis in an ovarian fibroma by immunohistochemistry.Case reportA 77-year-old post-menopausal woman presented with a left ovarian tumor, abnormal endometrial thickness, and high levels of estradiol (E2). The tumor was found to be a fibroma, which was positive for alpha-inhibin. We examined estrogen-producing enzymes using immunohistochemistry. The tumor was positive for estrogen receptor, progesterone receptor, 17β-hydroxysteroid dehydrogenase (HSD)-1, adrenal 4 binding protein/steroidogenic factor 1, 17β-HSD-5, steroid sulfatase, and P450c17.ConclusionThis case study shows that E2 can be locally produced from circulating inactive steroids, by estrogen-producing enzymes. This is the first report of steroid hormone synthesis in an ovarian fibroma. |
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| Keywords: | Estradiol Estrogen receptor Fibroma Gonadal steroid hormones Steroid sulfatase |
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