Ovarian theca cell tumor

Introduction to ovarian bleb cell tumor Ovarian vesicular cell tumors are basically benign tumors, which have obvious endocrine functions. Tumor cells can secrete estrogen. When luteal or cystic changes, a few may have masculine functions. There are only reports of malignant vesicular cell tumors. Ovarian vesicular cell tumors are derived from the special mesenchymal tissue of the ovarian stroma and differentiate into the ovarian membrane cells to form tumors. basic knowledge The proportion of illness: 0.005% Susceptible people: women Mode of infection: non-infectious Complications: intestinal obstruction, pulmonary embolism, ascites, peritonitis

Ovarian vesicular cell tumor etiology

(1) Causes of the disease

Ovarian vesicular cell tumor is derived from the special mesenchymal tissue of the ovarian stroma, and differentiates into the follicular cells to form a tumor. Some scholars have found through the cellular genetic analysis that the vesicular cell tumor has the 12th found in other sexual cord stromal tumors. Trisomy 12, a mesangial cell tumor also has a chromosome 3 trisomy (Trisomy 4), and the latter is considered to be the second tumor gene of a vesicular cell tumor.

(two) pathogenesis

Membrane cell tumor

(1) gross examination: the tumor is mostly unilateral, rare on both sides, diameter 1 ~ 30cm, average diameter 8cm, round or oval, appearance often bulging, superficial lobulated, solid tumor, hard Or tough, cut surface solid, can have different degrees of cystic cavity, even visible hemorrhagic foci, yellow, apricot yellow spots or areas divided by gray fiber tissue is characterized by focal or diffuse edema.

(2) Examination under the microscope:

1 Tumor cell characteristics: the tumor cells are round or short fusiform; the nucleus is round or oval; the cytoplasm is rich, uniform or vacuolized, the boundary is unclear, the HE stain is light, the fat staining is positive, and the rich lipid droplets are visible. Reticulated fiber staining shows that argyrophilic fibers surround each cell, which is a commonly used histochemical identification method for granulosa cell tumors.

2 Tumor cell tissue arrangement: tumor cells are arranged in bundles, intersecting each other, and the cell bundles are thread-like or trabecular with each other. The interspersed cell bundles are separated by fibrous connective tissue interstitial, and common glass-like changes (figure 1).

2. Luteinized vesicular cell tumor refers to the luteinization of cells in the vesicular cell tumor. At this time, the tumor cells are large, polygonal or round, and rich in lipids. This luteinized cell is often distributed in the vesicular cell tumor. Inside, fibrous interstitial is common and large, glassy.

3. Membrane fibroma with Leydig cells When there are scattered or piles of cells like Leydig cells in the tumor, if Reinke-like crystals can be found, they are called cell tumors containing Leydig cells.

4. Malignant vesicular cell tumor is rare, only case reports, tumor cells dense, sarcomatoid, epithelioid or heteromorphic, nuclear large, abnormal, mitotic multi-[(30 ~ 40) / 10HPFs], and visible pathological mitosis Tumor dissemination and metastasis may occur clinically. Some authors believe that only the above morphological manifestations are not sufficient to diagnose malignancy, and tumors must be functionally diagnosed. Currently, due to the small number of cases, the diagnostic criteria for malignant vesicular cell tumors have not yet been diagnosed. Unite.

Ovarian vesicular cell tumor prevention

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Ovarian vesicular cell tumor complications Complications, intestinal obstruction, pulmonary embolism, ascites peritonitis

Combined with luteinized vesicular cell tumor, all the 6 patients had intestinal obstruction. The surgical exploration revealed that the peritoneal fibrous thickening was 4~5mm, and it could involve the greater omentum, small intestine, etc., under the microscope, the peritoneal lesion was Collagen fibers or fibrous tissue-divided proliferating fibroblasts, composed of smooth muscle cells, with chronic inflammatory cell infiltration, 3 cases of ovarian lesions are solid masses of 12 to 31 cm in diameter, and 3 of the ovaries are only slightly enlarged and knotted. The nodules and microscopic examination were all lentinated vesicular cell tumors. One of the 6 patients died of pulmonary embolism 2 months after surgery, and 4 patients were followed up for 8 months to 6 years without tumor recurrence. Similar cases It has not been reported in China, but it should be brought to the attention of clinicians. Patients with ovarian solid tumors with symptoms of ascites, intestinal obstruction and endocrine disorders should be alert to the presence of rare sclerosing peritonitis.

Ovarian vesicular cell tumor symptoms Common symptoms Abdominal pain Menstrual volume Multi-abdominal discomfort Ascites Vaginal irregular bleeding Amenorrhea Bloating Postmenopausal bleeding Male

Symptoms and signs

(1) Estrogen increase: Because the tumor secretes estrogen, the endometrium acts as the target organ, which can often cause proliferative lesions or cancerous changes. Clinical common vaginal irregular bleeding, menorrhagia, amenorrhea, postmenopausal bleeding and other symptoms, Normura et al. (2001) reported a case of vesicular cell tumor with uterine adenosarcoma.

(2) masculine performance: about 2% of cases have masculine manifestations, blood testosterone can be elevated, mainly in the presence of luteinization of the cell tumor, cystic changes occur, clinically patients with hairy, hemorrhoids, low voice A series of symptoms such as dumb, enlarged clitoris, breast atrophy, and low estrogen levels, the symptoms gradually improved and disappeared after tumor resection.

(3) Abdominal discomfort, abdominal distension, occasional tumor torsion, acute abdominal pain may occur, because young patients with vesicular cell tumors are rare, so there are few reports of pregnancy, but the tumor is prone to rupture when combined with pregnancy, Takemori et al (2000 In a patient with vesicular cell tumor and ascites, plasma CA125 was also increased.

Examination of ovarian vesicular cell tumor

Hormone level detection. Histopathological examination.

Diagnosis and differentiation of ovarian vesicular cell tumor

diagnosis

Membrane cell tumor is a tumor with more clinical features. For elderly women, there are irregular vaginal bleeding symptoms, elevated estrogen levels, solid tumors attached, or a few people with masculine changes. Analysis considers the possibility of vesicular cell tumor, but because ovarian granulosa cell tumor has similar clinical symptoms, a few tumors contain both granulosa cell components and vesicular cell components, which is not easy for granulosa cell tumors. Accurate judgment before surgery often requires pathological examination to confirm the diagnosis. For such patients, preoperative diagnosis of ovarian granulosa-stromal cell tumor is completely correct.

Differential diagnosis

Identification with ovarian granulosa cell tumors.

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