Extra ovarian giant fibrothecoma; A case report of a 19 years old female patient.

Yıl 2024, Cilt: 15 Sayı: 2, 309 - 313, 01.07.2024

Ali Derinöz , Ertuğrul Genç , Cavit Çöl

https://doi.org/10.18663/tjcl.1485083

https://izlik.org/JA97CJ83EG

Öz

We report the case of extra-ovarian fibrothecoma in a young female patient in this article. She presented with sudden-onset abdominal pain, giant abdomino-pelvic mass, massive peritoneal ascites. Serum analysis were normal except high CA-125 level. The result of USG-guided percutaneous tru-cut biopsy was reported as mesenchymal tumor, but there aren’t any tumor-cell in ascite cytology. Total excision of tumor and left salpingo-oophorectomy procedure was performed. Histopathological diagnosis was reported as benign fibrothecoma. No complication were observed in postoperative period. SerumCA-125 levels returned to normal in a few days.

Anahtar Kelimeler

Fibrothecoma , ovary , CA-125

Ekstra ovaryen dev fibrotekoma; 19 yaşında genç kadın, hasta olgu sunumu

https://izlik.org/JA97CJ83EG

Öz

Bu çalışmada 19 yaşında genç kadın hastada görülen ekstra ovarian fibrothecoma olgusu sunulmuştur. Hasta bize karında hafif ağrı, dev abdominopelvik kitle, yaygın peritoneal asit ile başvurdu Kan tetkiklerin yüksek CA-125 düzeyi dışında normaldi. USG kılavuzluğunda yapılan perkütan tru-cut bx tanısı mezenkimal tümör idi, ancak asitt sitolojisinde tümör hücresi tespit edilemedi. Hastaya kitle eksizyonu ile birlikte sol salpingo-ooferektomi uygulandı. Patolojik tanı benign fibrotekoma olarak rapor edildi. Postoperatif dönem komplikasyonsuz seyretti. İzlem döneminde yüksek CA-125 düzeyi normal düzeylere indi.
Anahtar sözcükler: Fibrotekoma, CA-125, over

Anahtar Kelimeler

Fibrotekoma , CA-125 , over

Kaynakça

• Aubert O, Wachowiak R, Roth C, Höhn AK, Lacher M, Mayer S. Resection of an Extraovarian Noniuteinized Thecoma in a 14-Year-Old Girl. European J Pediatr Surg Rep. 2022 Apr 19;10(1):e37-e40. doi: 10.1055/s-0042-1742712. PMID: 35450099; PMCID: PMC9018130
• Maleki A, Khosravi M, Masrouri A. Ovarian thecoma presenting with acute ovarian torsion in pregnancy; report of a rare case. Clin Case Rep. 2022 Jun 26;10(6):e5986. doi: 10.1002/ccr3.5986. PMID: 35782220; PMCID: PMC9234059.
• Ting Y, Yang LI, Juan Z, Xing W, Feng YX. Ovarian thecoma with massive pleural effusion in postmenopausal women: A case report. Mol Clin Oncol. 2016 Jun;4(6):1003-1005. doi: 10.3892/mco.2016.853. Epub 2016 Apr 7. PMID: 27284435; PMCID: PMC4887833.
• Chen H, Liu Y, Shen LF, Jiang MJ, Yang ZF, Fang GP. Ovarian thecoma-fibroma groups: clinical and sonographic features with pathological comparison. J Ovarian Res. 2016 Nov 22;9(1):81. doi: 10.1186/s13048-016-0291-2. PMID: 27876070; PMCID: PMC5120502.
• Chung KC, Lee HH, Su MH, Chang WH, Lai WA, Wang PH. Ovarian fibrothecoma mimicking ovarian cancer: Using laparoscopy to avoid unnecessary exploratory laparotomy. Taiwan J Obstet Gynecol. 2019 Nov;58(6):903-904. doi: 10.1016/j.tjog.2019.09.026. PMID: 31759556.
• Kim YS, Lee HJ. A case report of two pelviscopic resections of fibrothecomas originating from the left ovary with recurrence after ten years. Medicine (Baltimore). 2023 Aug 18;102(33):e34880. doi: 10.1097/MD.0000000000034880. PMID: 37603501; PMCID: PMC10443753.
• Shen Y, Liang Y, Cheng X, Lu W, Xie X, Wan X. Ovarian fibroma/fibrothecoma with elevated serum CA125 level: A cohort of 66 cases. Medicine (Baltimore). 2018 Aug;97(34):e11926. doi: 10.1097/MD.0000000000011926. PMID: 30142807; PMCID: PMC6112998.
• Iavarone I, Padovano M, Pasanisi F, Della Corte L, La Mantia E, Ronsini C. Meigs Syndrome and Elevated CA-125: Case Report and Literature Review of an Unusual Presentation Mimicking Ovarian Cancer. Medicina (Kaunas). 2023 Sep 19;59(9):1684. doi: 10.3390/medicina59091684. PMID: 37763803; PMCID: PMC10535830.
• Zhang H, Zhang GF, Wang TP, Zhang H. Value of 3.0 T diffusion-weighted imaging in discriminating thecoma and fibrothecoma from other adnexal solid masses. J Ovarian Res. 2013 Aug 21;6(1):58. doi: 10.1186/1757-2215-6-58. PMID: 23962187; PMCID: PMC3751813.
• Hasegawa A, Koga K, Asada K, Wada-Hiraike O, Osuga Y, Kozuma S. Laparoscopic ovarian-sparing surgery for a young woman with an exophytic ovarian fibroma. J Obstet Gynaecol Res. 2013 Dec;39(12):1610-3. doi: 10.1111/jog.12107. Epub 2013 Jul 22. PMID: 23875949.
• Burandt E, Young RH. Thecoma of the ovary: a report of 70 cases emphasizing aspects of its histopathology different from those often portrayed and its differential diagnosis. Am J Surg Pathol. 2014 Aug;38(8):1023-32. doi: 10.1097/PAS.0000000000000252. PMID: 25025365.
• Roberts P, Nofech-Mozes S, Coburn N, Hamilton P, Gien LT. Retroperitoneal extraovarian fibrothecoma mimicking a malignant epithelial ovarian carcinoma. Case Rep Obstet Gynecol. 2012;2012:281745. doi: 10.1155/2012/281745. Epub 2012 Aug 15. PMID: 22928131; PMCID: PMC3426186.
• Heller DS, Harpaz N, Breakstone B. Neoplasms arising in ectopic ovaries: a case of Brenner tumor in an accessory ovary. Int J Gynecol Pathol. 1990;9(2):185-9. doi: 10.1097/00004347-199004000-00010. PMID: 2185167.
• Wu B, Peng WJ, Gu YJ, Cheng YF, Mao J. MRI diagnosis of ovarian fibrothecomas: tumour appearances and oestrogenic effect features. Br J Radiol. 2014 Jun;87(1038):20130634. doi: 10.1259/bjr.20130634. Epub 2014 Mar 27. PMID: 24670054; PMCID: PMC4075549.
• Gaspari L, Paris F, Taourel P, Soyer-Gobillard MO, Kalfa N, Sultan C. Adolescent ovarian thecoma presenting as progressive hyperandrogenism: case report and review of the literature. Gynecol Endocrinol. 2020 Sep;36(9):839-842. doi: 10.1080/09513590.2020.1739265. Epub 2020 Mar 16. PMID: 32174224.
• Adu-Bredu TK, Arkorful J, Appiah-Denkyira K, Wiafe YA. Diagnostic value of the sonographic whirlpool sign in the diagnosis of ovarian torsion: A systematic review and meta-analysis. J Clin Ultrasound. 2021 Sep;49(7):746-753. doi: 10.1002/jcu.23021. Epub 2021 May 22. PMID: 34021602.
• Li Z, Hu Q, Luo Z, Deng Z, Zhou W, Xie L. Analysis of magnetic resonance imaging features of ovarian thecoma. Medicine (Baltimore). 2020 May 22;99(21):e20358. doi: 10.1097/MD.0000000000020358. PMID: 32481327; PMCID: PMC7249889.
• Bottoni P, Scatena R. The Role of CA 125 as Tumor Marker: Biochemical and Clinical Aspects. Adv Exp Med Biol. 2015;867:229-44. doi: 10.1007/978-94-017-7215-0_14. PMID: 26530369.
• Slimani O, Ben Temim R, Ajroudi M, Makhlouf T, Mathlouthi N, Attia L. Contribution of ultrasound in the study of ovarian fibrothecomas: a series of 47 cases. Tunis Med. 2017 Jan;95(1):29-36. PMID: 29327766.
• Abdelazim IA, Abu-Faza M, Abdelrazek K, Amer OO, Shikanova S, Zhurabekova G. Ovarian Fibroma Commonly Misdiagnosed as Uterine Leiomyoma. Gynecol Minim Invasive Ther. 2019 Sep 18;9(1):36-38. doi: 10.4103/GMIT.GMIT_131_18. PMID: 32090012; PMCID: PMC7008642.
• Cho YJ, Lee HS, Kim JM, Joo KY, Kim ML. Clinical characteristics and surgical management options for ovarian fibroma/fibrothecoma: a study of 97 cases. Gynecol Obstet Invest. 2013;76(3):182-7. doi: 10.1159/000354555. Epub 2013 Sep 14. PMID: 24051436.