Cases reported "Neoplasms, Gonadal Tissue"

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1/12. Use of a long-acting gonadotrophin-releasing hormone analogue in a postmenopausal woman with hyperandrogenism due to a hilus cell tumour.

    OBJECTIVE: The aim of this study was to prove the utility of GnRH analogues for the suppression of androgen secretion in a postmenopausal woman with a suspected virilizing ovarian tumour. DESIGN AND methods: We present a case of a 72-year-old woman with virilization of recent onset. Hormonal studies revealed a fourfold increase in serum testosterone levels, normal dehydroepiandrosterone sulphate concentrations and high levels of serum 17-hydroxyprogesterone levels. Computed axial tomography scan of the ovaries was normal and the adrenal glands showed a discrete enlargement. The long-acting GnRH analogue, triptorelin, was injected initially (3.75mg i.m.) and serum hormone levels were measured weekly throughout one month. RESULTS: GnRH produced a decrease in serum testosterone levels to normal values, in parallel with the suppression of serum LH and FSH concentrations. The patient was treated for three months with triptorelin and she experienced an amelioration of the hyperandrogenic symptoms. In order to achieve a diagnosis, the patient was submitted to a laparotomy that revealed a small hilus cell tumour in the left ovary. CONCLUSION: GnRH analogues may offer a good therapeutic option in some states of gonadotrophin-dependent hyperandrogenism of ovarian origin.
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ranking = 1
keywords = cell tumour
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2/12. The steroid profile of a virilizing ovarian tumor.

    A case report of a 25-year-old female with a sex cord stromal virilizing ovarian tumor is presented. The pathway of ovarian steroid secretion in this tumor is elucidated with the dominant elements being pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, and testosterone. The tumor primarily made testosterone (T) with lesser elevations of androstenedione (A), dehydroepiandrosterone (DHEA), and dihydrotestosterone (DHT). Expert pathologic opinions differed whether this neoplasm was a Sertoli-Leydig tumor or a virilizing granulosa tumor; therefore, it was probably a gynandroblastoma. A unilateral salpingo-oophorectomy was performed and the patient promptly resumed normal ovarian function with ovulation.
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ranking = 4.5076504510337
keywords = granulosa
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3/12. Gynandroblastoma of the ovary. A case report.

    An ovarian gynandroblastoma was found in a 59-year-old woman. The tumor consisting of mixed Sertoli-leydig cells and granulosa-theca cells demonstrated no malignant features. Bisexual cells in gynandroblastoma derived from a common gonadal mesenchyme precursor or indifferent cell. The excision of appendages with tumor or hysterectomy was sufficient.
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ranking = 4.5076504510337
keywords = granulosa
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4/12. Gynandroblastoma of the ovary having a typical morphological appearance: a case study.

    A rare gynandroblastoma of the right ovary with a typical morphological appearance in a 65-year-old woman is reported. The tumor comprised both a granulosa cell element with a Call-Exner body and a Sertoli cell element. Pathologically, this case could be the most typical of all the world's established cases. Clinically, there were feminizing symptoms such as post-menopausal genital bleeding and endometrial cystic hyperplasia. Pre-operative serum hormonal assays indicated elevated levels of estrone, estradiol and testosterone, and low levels of gonadotropins. These returned to normal after surgery.
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ranking = 12.457397158044
keywords = granulosa cell, granulosa
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5/12. granulosa cell tumor of the ovary with sertoli-leydig cell tumor components (gynandroblastoma).

    A rare granulosa cell tumor with sertoli-leydig cell tumor components (gynandroblastoma) arising in the left ovary was reported in a 63-year-old female. Microscopically, the tumor was composed predominantly of granulosa cells arranged mainly in a diffuse solid pattern, but in some areas there were a trabecular pattern and thecofibromatous stromal components. Also, well-differentiated sertoli-leydig cell tumor elements were present as a minor component. The tumor produced, endocrinologically, a large amount of estradiol, some androstenedione and a small amount of testosterone. The possibility that estradiol in the present tumor was produced predominantly from androstenedione via estrone was suggested by the results of an in vitro biosynthetic study.
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ranking = 24.914794316089
keywords = granulosa cell, granulosa
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6/12. Gynandroblastoma: its ultrastructure.

    Gynandroblastoma is a rare, sex-cord stromal tumor of the ovary that shows morphologic evidence of female and male differentiation. Such a tumor produced masculinization in a 24-year-old woman, whose symptoms disappeared following removal of the tumor. By electron microscopy, the granulosa cell nests displayed Call-Exner (CE) bodies of the hyaline type composed of multiple layers of basal lamina resembling CE bodies of the normal graafian follicle. In contrast, CE bodies of a classic granulosa theca cell tumor were of the spongiform type, consisting of a space limited by a single basal lamina containing altered granulosa cells and cell processes. Both types of CE bodies are believed to arise following secretion by and/or degeneration of granulosa cells, the variation in morphology between the two resulting from differences in amounts of basal lamina deposited. The tubular components of the tumor resembled more closely the rete ovarii than did sertoli cells, and its proposed that such structures be called by the alternate and less specific term "androblastoma." The identity of leydig cells was established by demonstrated of intracytoplasmic Reinke crystals. Despite a difference in architectural pattern, there was a close ultrastructural resemblance between the different sex-cord components of the gynandroblastoma.
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ranking = 41.879841925167
keywords = granulosa cell, granulosa
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7/12. Hormone studies in a gynandroblastoma.

    plasma gonadotropin, testosterone, androstenedione, and estradiol levels were determined before and after removal of a 37-pound gynandroblastoma from an 18-year-old virilized, mentally retarded female. Testosterone and androstenedione levels preoperatively were in the normal female range and fell dramatically after castration. Histologic examination showed active atypical granulosa and Sertoli elements. The hormonal data obtained do not account for the marked virilization observed.
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ranking = 4.5076504510337
keywords = granulosa
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8/12. An ovarian lipid cell tumour causing virilization and Cushing's syndrome.

    We report a 73-year-old woman with rapidly developing symptoms and signs of Cushing's syndrome and high urinary free cortisol. She was virilized and hirsute with testosterone levels which became exceptionally high. ACTH was suppressed and CT scan of the adrenals and pelvis showed no abnormality. Ultrasound scanning showed enlargement of the left ovary. Venous catheter studies suggested a left ovarian source. A 2-cm diameter lipid cell tumor was removed from the left ovary laparoscopically. histology was initially benign, and clinical and biochemical cure of Cushing's syndrome was rapid. However, the neoplastic nature of the ovarian tumour was demonstrated 12 months later when peritoneal metastases were detected and there was then clinical and biochemical relapse.
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ranking = 0.8
keywords = cell tumour
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9/12. Gynandroblastoma of ovary with juvenile granulosa cell component and heterologous intestinal type glands.

    An ovarian gynandroblastoma in a 15-year-old girl is described. The predominant component was juvenile granulosa cell tumour. Areas of adult granulosa cell tumour and Sertoli cell elements were also present. Stromal theca and luteinised cells were identified. An additional histological finding was the presence of heterologous intestinal type glands. There was positive immunohistochemical staining of juvenile and adult granulosa cell areas with inhibin and MIC2 antibodies. Electronmicroscopy showed a close ultrastructural resemblance between tumour cells in granulosa and Sertoli cell areas, in spite of differences in architectural pattern, suggesting that both morphological components may derive from a single cell of origin. The tumour demonstrates a unique combination of elements which has not previously been described.
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ranking = 104.14827210498
keywords = granulosa cell, granulosa cell tumour, granulosa, cell tumour
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10/12. Gynandroblastoma of the ovary: a case report with an immunohistochemical and ultrastructural study.

    An ovarian gynandroblastoma in a 60-year-old woman is described. The cut-surface of the right ovary showed multiple macrofollicles separated by white fibrous tissues and multiple ill-defined yellowish nodules. The tumour consisted of substantial amount of a granulosa cell element and a Sertoli cell element with intermingled leydig cells. Immunohistochemically, the tumour cells in both the granulosa cell and Sertoli cell elements were positive for cytokeratin CAM5.2. The granulosa cell element showed strong membrane staining of Ewing's sarcoma antigen 013 and the Sertoli cell element was locally positive. vimentin was observed in both the Sertoli cell element and the granulosa cells. Both elements and the leydig cells were uniformly negative for epithelial membrane antigen, muscle specific actin, CD31 and CD34. The tumour was aneuploid by flow cytometry. The patient was well with no evidence of tumour five months after surgery.
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ranking = 49.829588632178
keywords = granulosa cell, granulosa
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