Sills Eric Scott, Doan Terrence B, Mock R James, Dixson George R, Rohlfing Michael B
Department of Obstetrics, Gynecology & Reproductive Research, Murphy Medical Center, Murphy, NC, USA.
Diagn Pathol. 2006 Sep 11;1:28. doi: 10.1186/1746-1596-1-28.
To describe immunohistochemical features encountered in ovarian fibrothecoma with correlation to clinical presentation and surgical management.
A female age 75 presented for evaluation of melena. The patient reported total abdominal hysterectomy and removal of both ovaries 40 years earlier.
CA-125 was normal and there was no evidence of hyperestrogen effect. Pelvic CT revealed a partially calcified 7 cm pelvic mass without adenopathy or ascites; ultrasound was confirmatory. Endoscopy identified three benign intestinal tubular adenomas. Following laparoscopic excision of the pelvic tumor immunohistochemical analysis of the mass showed negative staining for keratin, S100 protein, inhibin, calretinin, melan A, smooth muscle actin, CD34, CD117, and desmin. The tissue was positive for vimentin, however.
Ovarian fibrothecomas represent an ovarian stromal neoplasm developing in a wide spectrum of clinical settings. Particularly if oophorectomy is stated to have been performed remote from the time of index presentation, the status of the ovaries must be considered whenever pelvic pathology is encountered. We describe a calcified ovarian fibrothecoma identified during gastroenterology investigation and confirmed immunohistochemically via high amplitude vimentin signal.
描述卵巢纤维瘤的免疫组化特征，并将其与临床表现及手术治疗相关联。
一名75岁女性因黑便前来评估。患者报告40年前接受了全腹子宫切除术及双侧卵巢切除术。
CA-125正常，且无高雌激素效应的证据。盆腔CT显示一个7厘米的盆腔肿物，部分钙化，无淋巴结肿大或腹水；超声检查结果与之相符。内镜检查发现3个良性肠管状腺瘤。在腹腔镜切除盆腔肿瘤后，对肿物进行免疫组化分析显示，角蛋白、S100蛋白、抑制素、钙视网膜蛋白、黑素A、平滑肌肌动蛋白、CD34、CD117和结蛋白染色均为阴性。然而，该组织波形蛋白染色呈阳性。
卵巢纤维瘤是一种在多种临床情况下发生的卵巢间质肿瘤。特别是如果卵巢切除术是在本次就诊时间之前很久进行的，那么每当遇到盆腔病变时，都必须考虑卵巢的状态。我们描述了一例在胃肠病学检查期间发现的钙化性卵巢纤维瘤，并通过高幅度波形蛋白信号进行免疫组化确诊。
