[Estrogen production in epithelial tumors of the ovary--clinical and endocrinological study in postmenopausal women].

Estrogen-producing activity of common epithelial tumors (54 cases) and metastatic tumors (4 cases) of the ovary was clinically and endocrinologically studied in postmenopausal patients. High serum concentrations of E1 (greater than or equal to 50 pg/ml) and E2 (greater than or equal to 30 pg/ml) were demonstrated in 78% in the group of postmenopausal patients. Mucinous tumors were more commonly associated with high estrogen levels than serous tumors. Patients with malignant tumors more frequently have a high level of serum estrogen than those with benign tumors. Estrogen decreased to normal after complete resection of the tumor, but returned to the abnormal range following a recurrence. The local-peripheral gradient of the estrogen level was noted by measuring the estrogen concentration in the blood of the affected ovarian and peripheral veins at the time of laparotomy. These results indicated that serum estrogen in the patient was originally produced in the ovarian tumor mass. The increased estrogen were reflected in such target tissues as the endometrium and vaginal mucosa. Proliferation, hyperplasia, atypical hyperplasia and even a case of carcinoma of the endometrium were observed in patients with ovarian tumors. An increase in the karyopyknotic index (KPI) of the vaginal smear, as well as uterine bleeding, could be an important signs of asymptomatic ovarian tumors in postmenopausal women.