A small note of ovary sex cord/stromal tumor
Sex cord structure of ovary ->Â the embryonic structure that develop to ovarian follicle
Stroma of ovary -> connective tissue (fibroblast & Theca cell)
Granulosa cell tumor
- 2 types: adult (95%) & Juvenile (precocious sexual development)
- Associated w/Â *hyperestrogenism -> abnormal uterine bleeding *Increased inhibin -> may be useful for dx. & monitoring
- Potentially malignant (due to 5-25% recurrent and extension but less aggressive and metastasis), 10 year survival = 85%
- FOXL2 gene mutation (97% in adult type) -> granulosa cell development
- Gross🔎: large, solid, +/- cystic encapsulated masses
- Pathohistology🔬: cuboidal or polygonal cells in cords, sheets, or strands + gland or immature follicle like structure (Call-Exner bodies) + coffee bean shape nuclei (adult type)
Granulosa cell tumor histology from: https://commons.m.wikimedia.org/wiki/File:Granulosa_cell_tumour2.jpgÂ
Fibromas, Thecomas, and Fibrothecomas
- Fibromas (Fibroblast), Thecoma (thecas cells), Fibrothecoma (mixed)
- 4% of all ovarian tumors
- Presentation: Pelvic mass+ascites+hydrothorax (Meigs syndrome), pain, basal cell nevus syndrome
- Gross🔎:Solid, Spherical, hard, encapsulated grey-white mass
- Pathohistology🔬: Well differentiated fibroblasts + scant interspersed collagenous stroma
Sertoli-Laydig cell tumors
- Women all age, peaks at 2nd-3rd decades
- Often functional, leading to masculinization (eg. hirsutism, male hair distribution, clitoris hypertrophy) and defeminization (eg. amenorrhea, breast atrophy)
- DICER1 mutation -> dysregulation of micro RNA
- Gross🔎: unilateral, solid, gray to golden brown
- Pathohistology: Vary. From well differentiated (sertoli cell tubule + Laydig cells + stroma) to poorly differentiated (sarcomatous pattern)Â
Sertoli-leydig cell tumor (medium power) from:https://upload.wikimedia.org/wikipedia/commons/6/69/Ovary_SertoliLeydigCellTumor_MP3_CTR.jpg
Other sex cord/Stromal tumor
Hilus cell tumors (pure Leydig cell tumors)
- Rare
- Present with evidence of masculinization
- Gross🔎: unilateral, loburated, yellow or orange or red-brown color
- Pathohistology🔬: Vacuolated, eosinophilic round to polygonal cells +Reinke crystals
Pregnancy luteoma
- Non-neoplastic lesion in pregnancy
- Might presented with virilization
- Hyperplasia of luteinized cellsÂ
Gonadoblastoma
- Consisted of immature sertoli + granulosa cells. May have coexist dysgerminoma
- Found in patient with abnormal sexual development
Reference 1.Robbins & Cotran Pathologic Basis of Disease 10th Edition 2.https://www.pathologyoutlines.com/topic/ovarytumorgctadult.html 3.https://www.pathologyoutlines.com/topic/ovarytumorfibroma.html
I am currently just a final year med student, this is my study note and is not intended as medical advice. The content may contains inaccurency