Meigs' syndrome is a benign ovarian tumor associated with ascites and pleural effusion. Elevated cancer antigen 125 (CA-125) in Meigs' syndrome is an unusual clinical condition reported in few cases. We report here on a 61-year-old woman who presented with dyspnea; in imaging assessment, a heterogeneous pelvic mass measuring 12 x 11 cm with ascitic fluid was reported. Pleural effusion was detected on Chest X-ray. Aspiration of pleural fluid showed no evidence of malignancy. CA-125 level was 347 IU/mL. The patient underwent laparotomy during which a mass measuring 12 x 11 cm was detected in her left adnexa. Histology showed ovarian thecoma. The mass was resected, and, after that, the symptoms disappeared and CA-125 level reached 19 IU/mL. The patient had experienced no problem after 12 months of follow up. Although postmenopausal women with ovarian tumor, ascites, pleural effusion, and elevation of CA-125 levels probably have malignant ovarian tumors, Meigs' syndrome must be considered in the differential diagnosis.
Ascites ; Ascitic Fluid ; Diagnosis, Differential ; Dyspnea ; Female ; Follow-Up Studies ; Humans ; Laparotomy ; Meigs Syndrome* ; Middle Aged ; Pleural Effusion ; Thecoma ; Thorax

Ovarian fibrothecoma is a relatively new term that is used to describe an ovarian sex cord stromal tumour that has mixed features of both fibroma and thecoma. The prevalence of ovarian fibrothecoma tumours is very rare and is reported to be about 1.2% of all ovarian tumours. We report a case of a 32-year-old woman who presented with acute menorrhagia with no previous medical, surgical or gynecological history. She was amenorrhic for four years after the insertion of a levonorgestrelreleasing intrauterine system (LNG-IUS) for contraception. The efficacy and location of LNG-IUS was reflected due to the sudden onset of menorrhagia. On pelvic examination and ultrasound the LNG-IUS could not be visualized and a uterine fibroid was noted. A diagnostic laparoscopy was done to identify the LNG-IUS, which revealed an incidental large ovarian mass on the left ovary. CA-125 level was elevated to 45 kU/L (Normal range <35 kU/L). Total abdominal hysterectomy, left salpingo-oopherectomy and cystectomy were performed. On histopathology, the mass was proven to be an ovarian fibrothecoma. No signs of malignancy were noted on peritoneal fluid cytology. The LNG-IUS was found inside the uterus. Our case is reported on the basis of the rare incidence of ovarian fibrothecoma and the possible effect it may have on the efficacy of LNG-IUS causing menorrhagia.
Menorrhagia ; Fibroma ; Thecoma ; Ovarian Neoplasms

Sclerosing stromal tumor (SST) of the ovary is a rare, benign tumor. The most common clinical symptom is menstrual irregularity. Diagnosis of SST is often made by postoperative pathologic examination. The important differential diagnoses are other sex cord stromal tumors including fibroma, thecoma and etc. We present four cases of SST of the ovary during 10 years with a brief review of the literature.
Diagnosis, Differential ; Female ; Fibroma ; Ovary ; Sex Cord-Gonadal Stromal Tumors ; Thecoma

A 29-year-old woman presented with secondary amenorrhea, primary infertility, and virilization, which had developed over the past 2 years was suspected to have a virilizing tumor at her left ovary. Her serum testosterone level was markedly elevated (380 ng/dL). Left salpingooophorectomy was performed, and histopathological examination revealed a thecoma of the left ovary. The postoperative serum testosterone level returned to 65 ng/dL. The patient did not have regression of virilism soon. However, the patient had a normal menstruation 29 days after surgery and gave birth to a baby 13 months after surgery.
Adult ; Female ; Humans ; Menstruation ; Ovarian Neoplasms/blood/*complications/*surgery ; Ovariectomy ; Pregnancy ; Pregnancy Outcome ; Testosterone/blood ; Thecoma/blood/*complications/*surgery ; Virilism/blood/*etiology/surgery

Sclerosing stromal tumor (SST) is an uncommon benign tumor of the ovary, representing 2~6% of all stromal ovarian tumors. It is a distinct benign neoplasm that differs from fibromas, thecomas, luteinized tumors and steroid cell tumors. It presents most often with non-specific symptoms and tumor markers usually remain normal. However massive ascites is a rare symptom. We report a case of sclerosing stromal tumor with massive ascites and elevated CA 125 with brief review of literature.
Ascites ; Female ; Fibroma ; Lutein ; Ovary ; Thecoma ; Biomarkers, Tumor

Sclerosing stromal tumor (SST) is an uncommon benign tumor of the ovary, representing 2~6% of all stromal ovarian tumors. It is a distinct benign neoplasm that differs from fibromas, thecomas, luteinized tumors and steroid cell tumors. It presents most often with non-specific symptoms and tumor markers usually remain normal. However massive ascites is a rare symptom. We report a case of sclerosing stromal tumor with massive ascites and elevated CA 125 with brief review of literature.
Ascites ; Female ; Fibroma ; Lutein ; Ovary ; Thecoma ; Biomarkers, Tumor

OBJECTIVETo compare the sonographic findings with pathological features of ovarian thecoma, and to analyze the relationship between them.

METHODSThe sonograms of 45 ovarian thecoma cases were reviewed retrospectively and categorized into three subtypes as sound attenuation pattern, homogeneous hypoechoic pattern and solid and cystic mixed pattern. The pathological findings were classified as theca cell-predominant, fibroblast-predominant and mixed thecoma according to the cellular composition of the tumors. Hyaline degeneration and luteinization of the tumors were recorded. The pathologic findings of each subtype based on sonography were compared.

RESULTSOf the 45 patients, there were 34 (75.6%) solid ovarian lesions, 15 (33.3%) of those showed a sound-attenuation pattern with an anterior hypoechoic zone and posterior acoustic attenuation in sonography, the other 19 (42.2%) cases had homogeneous hypoechoic pattern with no posterior acoustic attenuation, and the remaining 11 (24.4%) cases presented as a solid and cystic mixed pattern. There were no significant differences in pathological cellular composition among the three sonographic subtypes. Five solid tumors containing hyaline degeneration and one with luteinization were found to have posterior acoustic attenuation. The solid and cystic mixed thecomas showed cystic degeneration and hemorrhage.

CONCLUSIONSolid ovarian thecomas usually have typical sonographic features, which may be associated with degeneration but not with cellular composition within the tumor.

Adult ; Aged ; Aged, 80 and over ; CA-125 Antigen ; blood ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; blood ; classification ; diagnostic imaging ; pathology ; Retrospective Studies ; Thecoma ; blood ; classification ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color ; methods ; Young Adult

Thecomas make up only 0.5% to 1% of ovarian tumors. They occur in woman predominantly in the perimenopausal and menopausal years. The average patient's age is between 50 and 55 years.1-3 Thecomas only rarely occur in children.4 These tumors can be associated with estrogen production but not as frequently as are granulosa cell tumors. They are mostly unilateral and rarely malignant, so exicion of ovary is adequate treatment.5 Recently, we experienced thecoma, causing precocious puberty in 6 year old girl. and report with brief review of literatures.
Estrogens ; Female ; Granulosa Cell Tumor ; Humans ; Ovary ; Puberty, Precocious ; Thecoma

Sclerosing stromal tumor (SST) is a rare benign neoplasm of ovarian stromal origin and predominantly affects young women in the second and third decades. This tumor characteristically differentiates itself histologically and clinically from both thecomas and fibromas. We present a case of huge SST of the ovary weighing 10 kg in a 71-year-old postmenopausal woman with a brief review of the literature.
Aged ; Female ; Fibroma ; Humans ; Ovary ; Thecoma

Sclerosing stromal tumor (SST) is a rare benign neoplasm of ovarian stromal origin and predominantly affects young women in the second and third decades. This tumor characteristically differentiates itself histologically and clinically from both thecomas and fibromas. We present a case of huge SST of the ovary weighing 10 kg in a 71-year-old postmenopausal woman with a brief review of the literature.
Aged ; Female ; Fibroma ; Humans ; Ovary ; Thecoma