Velamala Pavani, Gupta Parikshaa, Sikka Pooja, Kumar Divyesh, Rajwanshi Arvind
Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Midlife Health. 2021 Jan-Mar;12(1):82-84. doi: 10.4103/jmh.JMH_114_20. Epub 2021 Apr 17.
Steroid cell tumors of the ovary are rare sex-cord stromal tumors, accounting for approximately 0.1% of all ovarian neoplasms. Majority of these tumors are benign, occur in pre-menopausal women and are associated with hyperandrogenism. However, around one-third of cases are malignant and do not present with hormonal manifestations. A 48-year-old post-menopausal woman presented with complaints of gradually increasing progressive abdominal distension over the past 3 months. She had a history of weight gain but denied any symptoms of virilization. On examination, abdominal distension associated with ascites was noted. Serum CA125 level was raised. Contrast-enhanced computed tomography revealed a solid right adnexal mass. Based on the clinical impression of epithelial ovarian malignancy, the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy. Histopathological examination revealed steroid cell tumor of the not otherwise specified type in the right ovary with the capsular breach. However, all other organs, including the omentum were free of tumor. The index case is unique for its presentation in a post-menopausal woman, association with ascites, elevated CA125 levels and lack of any virilization manifestations. Establishing an early and accurate tissue diagnosis is essential so that appropriate surgical management can be done to prevent the development of metastases in potentially malignant cases.
卵巢类固醇细胞瘤是罕见的性索间质肿瘤，约占所有卵巢肿瘤的0.1%。这些肿瘤大多数为良性，发生于绝经前女性，与高雄激素血症有关。然而，约三分之一的病例为恶性，且无激素表现。一名48岁的绝经后女性主诉在过去3个月中腹部逐渐进行性膨隆。她有体重增加史，但否认有任何男性化症状。检查时，发现有与腹水相关的腹部膨隆。血清CA125水平升高。增强计算机断层扫描显示右侧附件有一实性肿块。基于上皮性卵巢恶性肿瘤的临床印象，患者接受了全腹子宫切除术、双侧输卵管卵巢切除术和结肠下大网膜切除术。组织病理学检查显示右侧卵巢为未另行分类的类固醇细胞瘤，有包膜破裂。然而，所有其他器官，包括大网膜均无肿瘤。该病例的独特之处在于其发生于绝经后女性，伴有腹水、CA125水平升高且无任何男性化表现。早期准确的组织诊断至关重要，以便在潜在恶性病例中进行适当的手术治疗以防止转移的发生。
