A Benign Ovarian Tumour developing an Endometrial Cancer? Sertoliform Ovarian Cystoadenoma getting together with an Endometrioid Adenocarcinoma
Keywords:Sertoliform Cystoadenoma, Endometrioid Adenocarcinoma Induction, Estrogenic Overproduction.
Introduction: Sertoli cells tumours are neoplasms with a very lowÂ incidence, being sertoliform cystoadenomae extremely unusual. ItsÂ first description was made on 1982 by Young and Roth, with veryÂ few cases published after them. This is a neoplasm only describedÂ on postmenopausal women, with an average age of presentation ofÂ 68 year old, and they could suffer virilization symptoms in differentÂ degrees. Histologically, it is a well differentiated neoplasm, with a lowÂ malignancy degree, and good prognosis if it is confined to ovaries. InÂ other way, the finding of this ovarian tumour getting together withÂ an endometrioid adenocarcinoma is an extremely rare case.
Medical Case:A 66 year old woman, who attended our officeÂ relating postmenopausal metrorrhage, is presented. The patient hadÂ a medical history of diabetes mellitus type II, arterial hypertension,Â dyslipidemia, liver steatosis, glaucoma and appendectomy. She gotÂ three deliveries and had her menopause at the age of 53.Â An outpatient hysteroscopy was carried on, finding three endometrialÂ polyps, two of them appeared as normal, and the bigger one hadÂ a glandular appearance with atypical vascularization, taking biopsyÂ of it that was informed as endometrioid type adenocarcinoma withÂ mucus-secreting pattern.Â Ultrasoud scanning, magnetic resonance and serum Ca 125 wereÂ carried on, finding a 2,5cm left ovarian nodule with negative CaÂ 125. An abdominal total hysterectomy with double adnexectomy, was carried on, with intraoperative biopsy, informed as a borderline tumour. Due to this finding, the operation was completed with omentectomy, lymphadenectomy and peritoneal washing. Last histological analysis identifies the ovarian tumour as sertoliform adenoma from rete ovarii, with hepatocyte multifocal metaplasia. This tumour is suspected of being estrogenic functioning one, probably was the inductor of low degree and moderatedly differentiated G2 endometrioid adenocarcinoma. There was no lymphatic or omental metastases. FIGO staging IA, TNM staging T1aN0M0.
Conclusions: Sertoliform cystoadenoma is a very rare finding, withÂ only few cases reported. It could be an estrogenic functioning tumourÂ and due to this characteristic could induce endometrial hyperplasia,Â and at last, could be the reason for appearance of low malignancyÂ degree endometrial neoplasms.
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