1/6. Ovarian luteinized thecoma with sclerosing peritonitis in an adult woman treated with leuprolide and toremifene in complete remission at 5 years.BACKGROUND: Luteinized thecoma of the ovary associated with sclerosing peritonitis is a rare pathologic condition without a standard strategy of treatment. CASE: We present the case of an ovarian luteinizing sclerosing thecoma in a 39-year-old woman. The patient underwent three laparotomic operations for subocclusive symptoms, revealing in both occasions the presence of sclerosing peritonitis, with large abdominal masses, including cysts containing clear fluid. Treatment with toremifene 20 mg/day and leuprolide resulted in a dramatic improvement of the performance status and complete remission of all the abdominal lesions. After 60 months follow-up, the patient is still disease-free. DISCUSSION: Antiestrogens plus LHRH agonists might be a noninvasive, effective and well-tolerated therapy for sclerosing peritonitis in patient operated for luteinized thecomas.- - - - - - - - - - ranking = 1keywords = thecoma (Clic here for more details about this article) |
2/6. Sclerosing stromal tumor of ovary.A case of an extremely rare, benign ovarian lesion occurring in young women is presented and its pathology discussed. Radiographically it simulated a large calcified fibroid. The diagnosis should be considered in a young woman with menstrual irregularity and pelvic mass where fibroma and thecoma are unlikely.- - - - - - - - - - ranking = 0.14285714285714keywords = thecoma (Clic here for more details about this article) |
3/6. Intra-abdominal desmoplastic small cell tumour in a patient with peutz-jeghers syndrome.A surgical case of intra-abdominal desmoplastic small cell tumour with divergent differentiation (IDS-CT) in a patient with peutz-jeghers syndrome (PJS) is reported. The patient was a 23-year-old woman who underwent surgery for a tumour in the left paraovarian region. Widespread peritoneal metastases were noted. Histopathological examination revealed solid cell nests composed of medium-sized cells demarcated by desmoplastic stroma. Gland-like spaces were found within many cell nests. Tumour cells were positive for cytokeratin and smooth muscle actin, but negative for desmin. Both ovaries contained minute foci of a sex cord tumour with annular tubules. This is the first documentation of the association of IDSCT with PJS. Since patients with PJS have an increased risk of cancer in various organs, the occurrence of IDSCT in the present patient might not be fortuitous.- - - - - - - - - - ranking = 0.0022661776148294keywords = cell tumour (Clic here for more details about this article) |
4/6. Luteinized thecoma with sclerosing peritonitis presenting as an acute abdomen.The seventh reported case of luteinized thecoma with sclerosing peritonitis is described. Unlike the other reported patients with this condition, the patient presented with a short history of secondary amenorrhea, a subsequent acute abdomen, and an absence of abdominal distention and ascites. The tumor had undergone extensive hemorrhagic necrosis secondary to infarction, and the patient's amenorrhea may have been secondary to the release of steroid hormones from the necrotic cells. The presence of extensive necrosis and a brisk mitotic rate raised the suspicion of a malignant thecoma, but the finding of subserosal fibrosis in the biopsied omental tissue led to the diagnosis of a benign luteinized thecoma with sclerosing peritonitis.- - - - - - - - - - ranking = 1keywords = thecoma (Clic here for more details about this article) |
5/6. Luteinized thecoma with sclerosing peritonitis.Clement and colleagues recently described a group of six patients who had spindle cell proliferations of the ovary resembling luteinized thecomas. A fatal case of extensive sclerosing peritonitis associated with an identical ovarian proliferation is reported. In addition, several other cases in the literature that almost certainly represent the same disease entity have been identified. To our knowledge, this report increases the number of cases to 13. The extensive peritoneal disease along with the high mitotic activity of the ovarian tumor resulted in the diagnosis of peritoneal dissemination of an ovarian cancer in some cases, including the one currently described. awareness of this newly described condition, which may be more common than previously thought, may help prevent further misdiagnosis.- - - - - - - - - - ranking = 0.71428571428571keywords = thecoma (Clic here for more details about this article) |
6/6. Sclerosing peritonitis associated with luteinized thecoma of the ovary.A unique case of bilateral luteinized thecomas of the ovary associated with sclerosing peritonitis is reported and the clinical and pathological features of this and previously reported cases are reviewed. The patient, 52 years of age, presented with abdominal distension and diarrhea. Pelvic imaging studies revealed bilateral ovarian tumors with ascites. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with adhesiotomy of the small bowel were performed. Histologically, the ovarian tumor was composed of closely packed spindle to round-shaped cells, and within the spindle cell population, lutein-like cells were scattered singly or in clusters. Mitotic counts of spindle cells revealed 12 mitotic figures (MF) per 10 high-power fields (HPF) in one part of the left ovarian tumor, but other areas of the tumor showed less than 3 MF/10 HPF on average. The lesion from the resected small bowel showed prominent fibrosis, confined to the serosa with no evidence of metastasis from the ovarian tumor. The patient has undergone adhesiotomy with partial resection of the small bowel seven times since the first laparotomy because of the recurrent small bowel obstruction. The patient has survived with complications due to short bowel syndrome for 7 years after the initial surgery and so far no recurrence or metastasis of the ovarian tumor has been identified. The case reported here also supports the idea that luteinized thecoma of the ovary associated with sclerosing peritonitis may be a distinct clinicopathologic entity, in terms of the unique association and of the unique features of thecoma; that is, bilateral, hormonally inactive and apparently benign in spite of its highly mitotic activity. Additional attention should be paid to the patient's quality of life, which is often degraded by peritoneal fibrosis and small bowel obstruction.- - - - - - - - - - ranking = 1keywords = thecoma (Clic here for more details about this article) |