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Xu Y, Shang HK. Recurrent steroid cell tumor not otherwise specified with elevated testosterone and prolactin concentrations and impaired glucose metabolism: a case report. J Int Med Res 2023; 51:3000605231194509. [PMID: 37669440 PMCID: PMC10481706 DOI: 10.1177/03000605231194509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/27/2023] [Indexed: 09/07/2023] Open
Abstract
Steroid cell tumor not otherwise specified (SCT-NOS) is a rare type of sex cord-stromal tumor with malignant potential. A 19-year-old woman underwent laparoscopic bilateral cystectomy, and postoperative pathology showed bilateral ovarian SCT-NOS. She had recurrence of the right tumor 8 years after the surgery, with shortened menstrual cycles, elevated testosterone and prolactin concentrations, and impaired glucose metabolism. We performed a laparoscopic right salpingo-oophorectomy. Testosterone and prolactin concentrations rapidly decreased and returned to the normal range after surgery. Subsequently, she had regular menstrual cycles and good glycemic control. The findings in our case suggest that there is a possibility of late recurrence in SCT-NOS. Therefore, we suggest that the postoperative follow-up period should be 10 years for this condition.
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Affiliation(s)
- Yuan Xu
- The Fourth Clinical School of Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hong-Kai Shang
- Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Schnuckle EM, Williamson A, Carpentieri D, Taylor S. Ovarian Sex Cord Stromal Tumor, Steroid Cell, NOS in an Adolescent: A Case Report. J Pediatr Adolesc Gynecol 2021; 34:94-97. [PMID: 32781238 DOI: 10.1016/j.jpag.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/10/2020] [Accepted: 08/02/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ovarian steroid cell tumor, not otherwise specified (NOS), is a rare type of sex cord stromal tumor, which often presents with androgenic symptoms and has a high frequency of malignancy. CASE This is a case of a 14-year-old Native American girl who presented with acne, amenorrhea, and virilization and was found to have a 2.9-cm solid ovarian mass. Initial pathology revealed steroid-appearing cells with round nuclei, clear/vacuolated cytoplasm, and a low mitotic index. Final diagnosis was ovarian steroid cell tumor, NOS Stage IA. A laparoscopic left salpingo-oophorectomy was subsequently performed. No tumor recurrence was noted 2 years after her initial diagnosis. SUMMARY AND CONCLUSION Long-term data on these tumors are limited; however, malignancy, recurrence, and death have been reported. This suggests that close follow-up is essential for appropriate management.
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Affiliation(s)
| | - Amy Williamson
- Department of Pediatric and Adolescent Gynecology, Phoenix Children's Hospital, Phoenix, Arizona.
| | - David Carpentieri
- Department of Pathology, Phoenix Children's Hospital, Phoenix, Arizona
| | - Steve Taylor
- Department of Pathology, Phoenix Children's Hospital, Phoenix, Arizona
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Yoshimatsu T, Nagai K, Miyawaki R, Moritani K, Ohkubo K, Kuwabara J, Tatsuta K, Kurata M, Fukushima M, Kitazawa R, Hamada J, Ochi F, Eguchi-Ishimae M, Tauchi H, Eguchi M. Malignant Ovarian Steroid Cell Tumor, Not Otherwise Specified, Causes Virilization in a 4-Year-Old Girl: A Case Report and Literature Review. Case Rep Oncol 2020; 13:358-364. [PMID: 32355490 PMCID: PMC7184839 DOI: 10.1159/000506044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 01/16/2020] [Indexed: 12/12/2022] Open
Abstract
We report a case of a 4-year-old girl with an ovarian steroid cell tumor, not otherwise specified (SCT-NOS). She was admitted to the hospital with progressing virilization and Cushing's syndrome, which included abnormality of the perineum, hirsutism, hypertrichosis, flushing of face, hoarseness, and weight gain. Blood testing showed a significantly increased testosterone level and slightly increased cortisol level. Computed tomography scan revealed an 8.0 × 5.0 × 5.0 cm tumor of the right ovary. The patient underwent right salpingo-oophorectomy, and pathological examination showed malignant potential. Three courses of bleomycin, etoposide, and cisplatin were administered as postoperative chemotherapy. After tumor resection, her testosterone decreased to undetectable levels. However, during the course of the treatment, the patient suffered from adrenal insufficiency resulting in the need for hydrocortisone replacement therapy. Although SCT-NOS in childhood are typically benign, pathological findings should be carefully observed for potential malignancy. In cases of cortisol-producing SCT-NOS, serum levels should be monitored, and hydrocortisone replacement therapy should be considered before resection.
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Affiliation(s)
- Takaharu Yoshimatsu
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kozo Nagai
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Reiji Miyawaki
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kyoko Moritani
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kazuhiro Ohkubo
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan.,Department of Community and Emergency Medicine, Ehime University Graduate School of Medicine, Toon, Japan
| | - Jun Kuwabara
- Department of Pediatric Surgery, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kyosuke Tatsuta
- Department of Pediatric Surgery, Ehime University Graduate School of Medicine, Toon, Japan
| | - Mie Kurata
- Department of Analytical Pathology, Ehime University Graduate School of Medicine, Toon, Japan.,Proteoscience Center Division of Pathology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Mana Fukushima
- Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan
| | - Riko Kitazawa
- Division of Diagnostic Pathology, Ehime University Hospital, Toon, Japan
| | - Junpei Hamada
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Fumihiro Ochi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | | | - Hisamichi Tauchi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
| | - Mariko Eguchi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
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Szeliga A, Zysnarska A, Podfigurna A, Maciejewska-Jeske M, Moszyński R, Sajdak S, Jasiński P, Frankowski A, Genazzani AR, Męczekalski B. Ovarian steroid cell tumor as an example of severe hyperandrogenism in 45-year-old woman. Gynecol Endocrinol 2020; 36:303-307. [PMID: 31718336 DOI: 10.1080/09513590.2019.1689551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Approximately, 5% of ovarian tumors have hormonal activity. Steroid cell tumors (SCTs) represent about 0.1% of all ovarian tumors. They cause hyperandrogenism associated with typical virilization. In this case report, we present 45-year-old women with unmalignant ovarian SCT-producing androgens which cause severe virilization and secondary amenorrhea lasting two years. Transvaginal ultrasound, computed tomography of adrenal glands, magnetic resonance imaging of small pelvis, laboratory tests (including serum concentration of FSH, LH, testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEA-S), as well as ROMA index) were performed. During hormonal evaluation, elevated concentrations of serum T - on admission 1.72 ng/ml and one month later 3.75 ng/ml (normal range 0.08-0.82 ng/ml) and A - 24.90 ng/ml (normal range 0.40-3.40 ng/ml) were found. The ROMA index was within the normal range. Enlargement of the left ovary by solid mass 56 × 43 mm was found during ultrasound examination. Based on small pelvis MRI scan and hormonal finding, patient was qualified for laparotomy. During this procedure, the left salpingo-oophorectomy with removal of the tumor was performed. The histopathological examination identified SCT. During follow-up examination, one day after surgery, we found serum testosterone levels within normal ranges - 0.74 ng/ml (normal range 0.08-0.82 ng/ml). This case shows that hormone-producing ovarian tumors are rare but very important clinical causes of severe hyperandrogenism.
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Affiliation(s)
- Anna Szeliga
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Zysnarska
- Students Scientific Society of the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Podfigurna
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Rafał Moszyński
- Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Stefan Sajdak
- Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Jasiński
- Department of Pathology, Gynecological and Obstetric Clinical Hospital in Poznan, Poznan, Poland
| | - Andrzej Frankowski
- Department of Pathology, Gynecological and Obstetric Clinical Hospital in Poznan, Poznan, Poland
| | - Andrea R Genazzani
- Department of Reproductive Medicine and Child Development, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy
| | - Błażej Męczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
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Nakasone T, Nakamoto T, Matsuzaki A, Nakagami H, Aoki Y. Direct evidence on the efficacy of GnRH agonist in recurrent steroid cell tumor-not otherwise specified. Gynecol Oncol Rep 2019; 29:73-75. [PMID: 31372485 PMCID: PMC6660559 DOI: 10.1016/j.gore.2019.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/02/2019] [Accepted: 07/15/2019] [Indexed: 11/03/2022] Open
Abstract
Background Steroid cell tumor (SCT) not otherwise specified (NOS) is rare and recurrence and metastasis rarely occurs; therefore, reports regarding its treatment are limited. We report a case of recurrent SCT-NOS treated with gonadotropin releasing hormone agonist (GnRHa) and successful. Case A 50-year-old woman underwent a staging laparotomy and diagnosed as SCT-NOS. Multiple liver tumors and intraperitoneal dissemination were detected 5 years 10 months after the initial surgery. As the immunohistochemical analysis showed positive staining for GnRH receptor, GnRHa was attempted. After the first cycle the serum testosterone level was normalized and after six cycles CT scan confirmed reduction of the tumor size. Conclusion Some ovarian SCT-NOS have GnRH receptors; thus, GnRHa may have a reducing effect for these tumors without major adverse event.
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Affiliation(s)
- Tadaharu Nakasone
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan.,Department of Obstetrics and Gynecology, Okinawa Prefectual Yaeyama Hospital, Japan
| | - Tomoko Nakamoto
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
| | - Akiko Matsuzaki
- Division of Pathology, Graduate School of Medicine, University of the Ryukyus, Japan
| | - Hiroshige Nakagami
- Department of Obstetrics and Gynecology, Okinawa Prefectual Yaeyama Hospital, Japan
| | - Yoichi Aoki
- Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Japan
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Chun YJ, Choi HJ, Lee HN, Cho S, Choi JH. An asymptomatic ovarian steroid cell tumor with complete cystic morphology: A case report. Obstet Gynecol Sci 2013; 56:50-5. [PMID: 24327981 DOI: 10.5468/OGS.2013.56.1.50] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 10/13/2012] [Accepted: 10/13/2012] [Indexed: 12/15/2022] Open
Abstract
Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. Of these, steroid cell tumors, not otherwise specified (NOS) constitute about 56% of all steroid cell tumors. Most steroid cell tumors secrete steroid hormones, and only about 10% to 15% of patients are asymptomatic. The morphology of steroid cell tumors, NOS is predominantly reported to be solid, and a review of case reports from 1979 until now revealed only 5 cases that were mainly cystic tumors. The present case, in a patient who had undergone a previous hysterectomy and surgery for a peritoneal inclusion cyst, is reported due to its rarity and its unusual presentation, together with a brief review of the literature. The tumor showed no clinical signs and symptoms typical of a steroid hormone secreting tumor and had an atypical morphology, being primarily multi-septate cystic with a minor solid portion.
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