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Kong M, Xu X, Xiang L, Wang C, Jiang T, Zhang X, Xie P. Case report: Ovarian steroid cell tumor with CA72-4 elevated. Gynecol Endocrinol 2024; 40:2400943. [PMID: 39254063 DOI: 10.1080/09513590.2024.2400943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/29/2024] [Accepted: 08/16/2024] [Indexed: 09/11/2024] Open
Abstract
Ovarian steroid cell tumor, not otherwise specified (SCT-NOS), is a rare subtype of sex cord-stromal tumor, characterized by hirsutism and virilization. There are, however, few tumor markers reported in the tumor. The following is a case report. Six years ago, the patient underwent a left adnexectomy after being diagnosed with a yolk sac tumor. Her serum CA72-4 levels were significantly elevated when she was diagnosed with SCT-NOS. She suffered from hirsutism and oligomenorrhea with long menstrual cycles. SCT-NOS was confirmed by her histopathological examination. When the tumor was diagnosed, serum CA72-4 levels were elevated. Following tumor resection, serum CA72-4 levels returned to the average reference interval. Whole-exome sequencing (WES) was utilized to identify ten mutations in MKI67, TICAM1, CHD3, ARID5B, ERBB4, POLD1, FZR1, MTCP1, TBX3, and CLTC genes.
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Affiliation(s)
- Min Kong
- Department of Obstetrics and Gynecology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Xiaoxuan Xu
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Longquan Xiang
- Department of Pathology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Changhe Wang
- Department of Obstetrics and Gynecology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Tao Jiang
- Department of Obstetrics and Gynecology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Xiangyu Zhang
- Department of Pathology, Jining No. 1 People's Hospital, Jining, Shandong, China
| | - Pengmu Xie
- Department of Obstetrics and Gynecology, Jining No. 1 People's Hospital, Jining, Shandong, China
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García-Álvarez N, Oleaga Á, García-Iglesias MJ, Pérez-Martínez C, Fernández D, Álvarez LM, Balsera R, Balseiro A. Ovarian Sex Cord Stromal Tumor in a Free-Ranging Brown Bear ( Ursus arctos). Animals (Basel) 2024; 14:1936. [PMID: 38998048 PMCID: PMC11240431 DOI: 10.3390/ani14131936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/14/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Reports on neoplasms in bears are scarce, especially concerning ovarian tumors. A large primary ovarian neoplasm with multiple metastasis was found during the necropsy of a 14-year-old free-ranging Eurasian brown bear (Ursus arctos) from Northwestern Spain. Histopathology and immunohistochemistry allowed for the diagnosis of a sex cord stromal tumor. This is a complex group of neoplasms which differ in the predominant cell morphology and immunohistochemical features. The microscopic examination revealed two types of cells, one with eosinophilic cytoplasm, intermingled with larger vacuolated cells rich in lipids. The evaluation of the immunoreactivity to different markers, frequently used in the characterization of gonadal tumors (INHA, inhibin-alpha; PLAP, placental alkaline phosphatase; Ki-67; α-SMA, actin alpha-smooth muscle) and inflammation patterns (IBA1, ionized calcium-binding adapter molecule for macrophages; CD3 for T lymphocytes; CD20 for B lymphocytes), displayed significant INHA positive immunostaining of neoplastic cells, as well as inflammatory cell infiltration, mainly composed of macrophages and B lymphocytes. These findings were consistent with a malignant ovarian steroid cell tumor, not otherwise specified. The present study characterizes an unusual type of neoplasm, and also represents the first report of an ovarian sex cord stromal tumor in Ursidae.
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Affiliation(s)
- Natalia García-Álvarez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, 24071 León, Spain
| | - Álvaro Oleaga
- Sociedad de Servicios del Principado de Asturias S.A. (SERPA), La Laboral, 33203 Gijón, Spain
| | | | - Claudia Pérez-Martínez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, 24071 León, Spain
| | - Daniel Fernández
- Sociedad de Servicios del Principado de Asturias S.A. (SERPA), La Laboral, 33203 Gijón, Spain
| | - Luis Miguel Álvarez
- Dirección General de Planificación Agraria del Principado de Asturias, 33007 Oviedo, Spain
| | - Ramón Balsera
- Dirección General de Planificación Agraria del Principado de Asturias, 33007 Oviedo, Spain
| | - Ana Balseiro
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, 24071 León, Spain
- Departamento de Sanidad Animal, Instituto de Ganadería de Montaña (CSIC-ULE), Finca Marzanas, Grulleros, 24346 León, Spain
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Lobaton-Ginsberg M, Malanco-Hernández LM, Ferreira-Hermosillo A. Rare virilizing tumor: ovarian steroid cell tumor, not otherwise specified: a case report. J Med Case Rep 2022; 16:478. [PMID: 36564842 PMCID: PMC9789566 DOI: 10.1186/s13256-022-03697-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/28/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Ovarian steroid cell tumors, not otherwise specified is a rare sex cord-stromal tumor. Almost 60% of all steroid cell tumors are categorized as not otherwise specified and represent less than 0.1% of all ovarian neoplasm. Some of them are endocrinologically active, producing virilization signs in young women. The recommended treatment is primarily surgical. CASE PRESENTATION We present the case of a 20-year-old Mexican woman with secondary amenorrhea and virilization signs. She was treated with combined oral contraceptives from 13 years old, due to a misdiagnosis of polycystic ovarian syndrome. However, 4 months after stopping medication, amenorrhea and virilization signs worsened. Biochemically, she had high serum total testosterone and free testosterone levels, and a pelvic and transvaginal ultrasound followed by a pelvic tomography scan demonstrated a right adnexal tumor. She underwent right salpingo-oophorectomy and the histopathological and immunochemistry exams confirmed the diagnosis. The patient was followed for a year after surgery and until then, her menses were regular and she had no recurrence of virilization signs. CONCLUSION The purpose of this case report is to alert physicians to rule out ovarian steroid cell tumor, not otherwise specified diagnosis in young women with increased testosterone after discarding common causes such as polycystic ovarian syndrome. A multidisciplinary team including a gynecologist, endocrinologist, radiologist, and pathologist should be involved for correct diagnosis at the proper time.
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Affiliation(s)
- Miry Lobaton-Ginsberg
- grid.440977.90000 0004 0483 7094Universidad Anáhuac México, Campus Norte, Mexico City, Mexico ,grid.418385.3Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Luz María Malanco-Hernández
- Centro Oncológico Estatal ISSEMyM, Instituto de Seguridad Social del Estado de México y Municipios, Toluca, Mexico
| | - Aldo Ferreira-Hermosillo
- grid.418385.3Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Hamdy O, Saleh GA, Eldegwi SA, Elsayed M, Metwally IH, Naguib R, Setit A. Multicentric adrenocorticotropic hormone -producing steroid cell tumor of the fallopian tube & broad ligament in a 15 year old girl. Gynecol Endocrinol 2020; 36:835-838. [PMID: 32091276 DOI: 10.1080/09513590.2020.1731451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Steroid cell tumors occur usually in the ovaries with very few reported cases of extra-ovarian origin. Our patient was a fifteen year old female, complaining from secondary amenorrhea and voice deepening. Values of serum cortisol, DHEA, FSH & LH were normal. Serum Testosterone was elevated while ACTH-pm was markedly elevated. MRI described bilateral solid para-ovarian masses. Exploration revealed two bilateral tubal extraluminal cysts & a right broad ligament cyst which were all excised. Pathological examination led to the diagnosis of steroid cell tumor. Serum testosterone & ACTH returned to normal levels after surgery with subsequent regression of the virilizing symptoms. We can conclude that extra-ovarian steroid cell tumors are extremely rare. They are usually presented with virilizing symptoms and hormonal abnormalities. Surgery is the main line of treatment.
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Affiliation(s)
- Omar Hamdy
- Surgical Oncology unit, Oncology center, Mansoura University, Mansoura, Egypt
| | - Gehad A Saleh
- Radiology department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Sara A Eldegwi
- Pathology department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Elsayed
- Endocrinology unit, Specialized medical hospital, Mansoura University, Mansoura, Egypt
| | - Islam H Metwally
- Surgical Oncology unit, Oncology center, Mansoura University, Mansoura, Egypt
| | - Reham Naguib
- Pathology department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Setit
- Surgical Oncology unit, Oncology center, Mansoura University, Mansoura, Egypt
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Ovarian Steroid Cell Tumor (Not Otherwise Specified): A Case Report of Ovarian Hyperandrogenism. Case Rep Oncol Med 2020; 2020:6970823. [PMID: 32328328 PMCID: PMC7168706 DOI: 10.1155/2020/6970823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/08/2019] [Accepted: 01/22/2020] [Indexed: 12/27/2022] Open
Abstract
Steroid cell tumors (SCTs) (not otherwise specified (NOS)) are rare sex cord-stromal tumors of the ovary. These are associated with hormonal disturbances resulting in menstrual bleeding patterns and androgenic effects. We report the case of a 36-year-old female presented with hirsutism, signs of virilization, and elevated androgen levels. Transvaginal ultrasound showed a solid-appearing right ovarian mass. She underwent fertility-sparing surgery with a laparoscopic left oophorectomy. Histological examination showed a benign steroid cell tumor, NOS. These tumors often small can then present a problem of positive diagnosis responsible for a delay in the diagnosis.
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Díaz Trastoy O, Rodríguez Cañete B, Cabezas Agrícola J, Martínez Olmos M, Fraga Blanco P, Seoane Villaverde M, Bouso M, Casanueva F. Tumor de células esteroideas sin otra especificación: reporte de un caso. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2017. [DOI: 10.1016/j.gine.2016.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chuffa LGDA, Lupi-Júnior LA, Costa AB, Amorim JPDA, Seiva FRF. The role of sex hormones and steroid receptors on female reproductive cancers. Steroids 2017; 118:93-108. [PMID: 28041951 DOI: 10.1016/j.steroids.2016.12.011] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/10/2016] [Accepted: 12/24/2016] [Indexed: 02/08/2023]
Abstract
Sex steroids have been widely described to be associated with a number of human diseases, including hormone-dependent tumors. Several studies have been concerned about the factors regulating the availability of sex steroids and its importance in the pathophysiological aspects of the reproductive cancers in women. In premenopausal women, large fluctuations in the concentration of circulating estradiol (E2) and progesterone (P4) orchestrate many events across the menstrual cycle. After menopause, the levels of circulating E2 and P4 decline but remain at high concentration in the peripheral tissues. Notably, there is a strong relationship between circulating sex hormones and female reproductive cancers (e.g. ovarian, breast, and endometrial cancers). These hormones activate a number of specific signaling pathways after binding either to estrogen receptors (ERs), especially ERα, ERα36, and ERβ or progesterone receptors (PRs). Importantly, the course of the disease will depend on particular transactivation pathway. Identifying ER- or PR-positive tumors will benefit patients in terms of proper endocrine therapy. Based on hormonal responsiveness, effective prevention methods for ovarian, breast, and endometrial cancers represent a special opportunity for women at risk of malignancies. Hormone replacement therapy (HRT) might significantly increase the risk of these cancer types, and endocrine treatments targeting ER signaling may be helpful against E2-dependent tumors. This review will present the role of sex steroids and their receptors associated with the risk of developing female reproductive cancers, with emphasis on E2 levels in pre and postmenopausal women. In addition, new therapeutic strategies for improving the survival rate outcomes in women will be addressed.
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Affiliation(s)
| | - Luiz Antonio Lupi-Júnior
- Department of Anatomy, IBB/UNESP, Institute of Biosciences of Botucatu, Univ. Estadual Paulista, SP, Brazil
| | - Aline Balandis Costa
- Department of Nursing, UENP/CLM - Universidade Estadual do Norte do Paraná, PR, Brazil
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Sood N, Desai K, Chindris AM, Lewis J, Dinh TA. Symptomatic Ovarian Steroid Cell Tumor not Otherwise Specified in a Post-Menopausal Woman. Rare Tumors 2016; 8:6200. [PMID: 27441075 PMCID: PMC4935824 DOI: 10.4081/rt.2016.6200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/09/2015] [Accepted: 12/16/2015] [Indexed: 12/18/2022] Open
Abstract
Steroid cell tumor not otherwise specified (NOS) is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms. The majority of tumors occur in pre-menopausal women (mean age: 43 years), in which 56-77% of patients present with virilization due to excess testosterone. An 80-year-old woman with worsening alopecia and excessive growth of coarse hair on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL). Radiologic studies were consistent with bilateral adrenal adenomas. Bilateral adrenal venous sampling ruled out the adrenal gland as origin of hormone secretion. A diagnostic and therapeutic bilateral salpingo-oophorectomy confirmed steroid cell tumor NOS of the left ovary. Post-operatively, the patient had complete resolution of her symptoms and normalization of testosterone level. Our case emphasizes the importance of a clinical suspicion for an occult testosterone secreting ovarian tumor in a symptomatic patient without obvious ovarian mass on imaging.
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Affiliation(s)
- Neha Sood
- Department of Medical and Surgical Gynecology
| | | | | | - Jason Lewis
- Department of Pathology, Mayo Clinic , Jacksonville, FL, USA
| | - Tri A Dinh
- Department of Medical and Surgical Gynecology
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