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  • Ovarian Stromal Tumors Atf

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    Granulosa cell tumors are the most common ovarian stromal tumor and are derived from granulosa cells. They often secrete estrogens and present with symptoms of excess estrogen production like uterine bleeding. Fibromas are benign ovarian tumors of fibroblasts that usually present as a pelvic mass and can be associated with ascites or Meigs syndrome. Sertoli-Leydig cell tumors are rare tumors of the ovary that produce androgens and cause masculinizing symptoms.

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    Granulosa cell tumors are the most common ovarian stromal tumor and are derived from granulosa cells. They often secrete estrogens and present with symptoms of excess estrogen production like uterine bleeding. Fibromas are benign ovarian tumors of fibroblasts that usually present as a pelvic mass and can be associated with ascites or Meigs syndrome. Sertoli-Leydig cell tumors are rare tumors of the ovary that produce androgens and cause masculinizing symptoms.

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    9 views11 pages

    Ovarian Stromal Tumors Atf

    Uploaded by

    shashankkokkula1704
    Granulosa cell tumors are the most common ovarian stromal tumor and are derived from granulosa cells. They often secrete estrogens and present with symptoms of excess estrogen production like uterine bleeding. Fibromas are benign ovarian tumors of fibroblasts that usually present as a pelvic mass and can be associated with ascites or Meigs syndrome. Sertoli-Leydig cell tumors are rare tumors of the ovary that produce androgens and cause masculinizing symptoms.

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    of 11

    AfraTafreeh.

    com

    Ovarian Stromal
    Tumors
    Jason Ryan, MD, MPH
    Ovary Structures
    • Oocytes (eggs)
    • Germ cell tumors
    • Supporting cells
    • Theca/granulosa
    • Fibroblasts AfraTafreeh.com
    • Sex cord stromal tumors
    • Surface epithelium
    • Adenomas/Carcinomas

    Wikipedia/Public Domain
    AfraTafreeh.com

    Stromal Cell Tumors


    • “Sex cord stromal tumors”
    • Fibroblasts, theca cells, granulosa cells
    • Often produce hormones

    Estradiol
    (17β-estradiol)
    Granulosa Cell Tumors
    • Most common ovarian stromal tumor
    • Tumors derived of granulosa-type cells
    • May contain theca cells (“granulosa-theca cell tumor”)
    • Secrete estrogens
    AfraTafreeh.com
    • Usually unilateral
    • May become malignant (“malignant potential”)
    AfraTafreeh.com

    Granulosa Cell Tumors


    • Adult subtype (95% cases)
    • Median age 50 to 54 years
    • Symptoms from excess estrogen production
    • Juvenile subtype
    • Develop before puberty
    • “Sexual precocity” from excess estrogen production
    • Puberty at very early age (usually < 8 years old)
    Granulosa Cell Tumors
    Clinical Features

    • Often present as large adnexal mass


    • Estrogen symptoms
    • Endometrial hyperplasia → uterine bleeding
    • Often bleeding in postmenopausal woman
    • Breast tenderness AfraTafreeh.com
    • Associated with endometrial carcinoma
    • Endometrial biopsy often performed
    AfraTafreeh.com

    Granulosa Cell Tumors


    Histology

    • Pathognomonic finding: Call-Exner bodies


    • Cells surrounding space filled with pink material

    Nephron/Wikipedia
    Fibroma
    • Benign tumors of fibroblasts
    • Solid, white tumor
    • Usually unilateral Ed Uthman, MD/Wikipedia

    • No hormone activity
    AfraTafreeh.com
    • Occur in postmenopausal women
    • Usually present as a pelvic/adnexal mass
    • Two classic clinical associations
    • Ascites
    • Meigs syndrome
    AfraTafreeh.com

    Ascites and Meigs Syndrome


    • Ascites occurs in 40% cases of ovarian fibroma
    • Meigs syndrome
    • Ovarian fibroma
    • Ascites
    • Pleural effusion
    • Etiology unclear
    • Probably related to capillary leak from tumor factors
    • Removal of tumor resolves ascites and effusion
    Thecoma
    • Usually co-exist with fibromas (“fibrothecoma”)
    • Pure thecoma: rare
    • May produce estrogens
    • May lead to endometrial hyperplasia/bleeding
    AfraTafreeh.com
    AfraTafreeh.com

    Sertoli-Leydig Cell Tumor


    • Tumor of Sertoli and Leydig cells
    • Often occur in males as testicular tumors
    • May occur in the ovary
    • Tumor produces androgens
    • Breast atrophy
    • Amenorrhea
    • Sterility (anovulation)
    • Hirsutism

    Wikipedia/Public Domain

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