Fibroma with minor sex cord elements – an incidental finding in a normal sized ovary A case report with literature review

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Abstract

Ovarian fibroma with minor sex cord element is a rare neoplasm. Microscopically it is composed of predominantly fibromatous or a thecomatous tumor containing scattered minor sex cord elements in less than 10% of the tumor area.

A case of fibroma with minor sex cord elements discovered incidentally in a normal sized ovary in a patient who presented with dysfunctional uterine bleeding is being presented. This is the first case report describing this entity in a normal sized ovary as an incidental finding.

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Ovarian stromal tumors containing lutein or Leydig cells (luteinized thecomas and stromal Leydig cell tumors)--a clinicopathological analysis of fifty cases.

R E Scully, Jian Zhang Quan, J Arseneau … (1981)

Fifty ovarian stromal tumors that had a predominant pattern of fibroma or thecoma but also contained cells typical of steroid hormone-secreting cells are reported. Forty-six tumors were classified as luteinized thecomas because the steroid cells resembled lutein cells and lacked crystalloids of Reinke. Four were classified as stromal Leydig cell tumors because crystalloids were identified in the steroid cells. The luteinized thecomas occurred at an average age of 46 years and were associated with estrogenic manifestations in 50% and androgenic changes in 11% of the cases. In the remaining cases there was no clinical or pathological evidence of steroid hormone production at the time of diagnosis. Six patients, two of whom were virilized, were pregnant. Four tumors appeared malignant on histologic examination. One of these tumors was rapidly fatal, the outcome is unknown in a second case, the third patient is alive and well at 5 years, and the fourth tumor was diagnosed too recently for evaluation of its behavior. The stromal Leydig cell tumors occurred at an average age of 61 years and were associated with virilization in one case, endometrial hyperplasia in another case, and endometrial hyperplasia with carcinoma in a third case. The fourth tumor was unassociated with endocrine manifestations. Luteinized thecomas and stromal Leydig cell tumors are indistinguishable except for the presence of crystalloids of Reinke in the latter. In view of the prolonged search that is necessary to find these structures in some stromal Leydig cell tumors and their well-known absence in the majority of testicular Leydig cell tumors, it is reasonable to assume that an unknown proportion of tumors in the luteinized thecoma category are unrecognized stromal Leydig cell tumors.

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Ovarian stromal tumors with minor sex cord elements: a report of seven cases.

R E Scully, Susan Young (1982)

Seven ovarian tumors that were predominantly stromal, but contained, in addition, a minor component of sex cord elements, were encountered in patients ranging from 16 to 65 years of age. The tumors varied from 1 to 10 cm in diameter and resembled grossly fibromas or thecomas. On microscopical examination they were predominantly fibromatous, but also contained small nests or tubules composed of cells resembling granulosa cells, Sertoli cells, or indifferent cells of sex cord type. Two tumors also had cells of steroid-hormone-cell type; these cells contained crystalloids of Reinke in one case. These two tumors were classified as luteinized thecoma and stromal-Leydig cell tumor with minor sex cord elements. The other five tumors were designated fibromas with minor sex cord elements. Five-year follow-up, available in three cases, revealed no evidence of recurrence after operative removal. Although the presence of sex cord components has generally resulted in the classification of an ovarian tumor in either the granulosa cell or Sertoli-Leydig cell category, we propose that tumors with only minor sex cord components be placed in a separate category.

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Fibrosarcoma of the ovary arising in a fibrothecomatous tumor with minor sex cord elements. A Case report and review of the literature.

Jane-Hwei Lee, Q Ahmed (2002)

We report the case of a 69-year-old woman who presented with postmenopausal bleeding. Endometrial curettings showed complex atypical hyperplasia with focal well-differentiated adenocarcinoma. A computed tomographic scan of the abdomen revealed a right ovarian mass. Histologically, the right ovarian tumor was a fibrothecoma with minor sex cord elements showing focal fibrosarcomatous change. Fibrosarcoma of the ovary is a rare tumor that is considered to arise de novo or secondary to benign fibromatous tumors. Fibrothecoma of the ovary with minor sex cord elements is also a rare entity. To the best of our knowledge, this is the first reported case of a fibrosarcoma arising in a fibrothecoma with minor sex cord elements.

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Journal

Journal ID (nlm-ta): Diagn Pathol

Title: Diagnostic Pathology

Publisher: BioMed Central

ISSN (Electronic): 1746-1596

Publication date Collection: 2007

Publication date (Electronic): 4 December 2007

Volume: 2

Page: 46

Affiliations

[1 ]Department Of Pathology, Maulana Azad Medical College, New Delhi-110002, India

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Publisher ID: 1746-1596-2-46

DOI: 10.1186/1746-1596-2-46

PMC ID: 2217290

PubMed ID: 18053193

SO-VID: 6d011e62-e3f2-4e36-963e-eec228bf3d43

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fibroma with minor sex cord elements – an incidental finding in a normal sized ovary A case report with literature review

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Most cited references 8

Ovarian stromal tumors containing lutein or Leydig cells (luteinized thecomas and stromal Leydig cell tumors)--a clinicopathological analysis of fifty cases.

Ovarian stromal tumors with minor sex cord elements: a report of seven cases.

Fibrosarcoma of the ovary arising in a fibrothecomatous tumor with minor sex cord elements. A Case report and review of the literature.

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