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Can a Benign Ovarian Tumour develop a Malignant Endometrial Neoplasm? Sertoliform Ovarian Cystoadenoma getting together with a Low Malignancy Degree Endometrioid Adenocarcinoma G2


Abstract

Introduction:

 

Sertoli cells tumours are neoplasms with a very low incidence, being sertoliform cystoadenomae extremely unusual. Its first description was made on 1982 by Young and Roth, with very few cases published after them. This is a neoplasm only described on postmenopausal women, with an average age of presentation of 68 year old, and they could suffer virilization symptoms in different degrees. Histologically, it is a well differentiated neoplasm, with a low malignancy degree, and good prognosis if it is confined to ovaries. In other way, the finding of this ovarian tumour getting together with an endometrioid adencarcinoma is an extremely rare case.

 

 

 

Medical Case:

 

A 66 year old woman, who attended our office relating postmenopausal metrorrhage, is presented. The patient had a medical history of diabetes mellitus type II, arterial hypertension, dyslipidemia, liver steatosis, glaucoma and appendectomy. She got three deliveries and had her menopause at the age of 53.

An outpatient hysteroscopy was carried on, finding three endometrial polyps, two of them appeared as normal, and the bigger one had a glandular appearance with atypical vascularization, taking biopsy of it that was informed as endometrioid type adenocarcinoma with mucus-secreting pattern.

Ultrasoud scanning found an adnexal left 2.5 cm nodule with heterogeneous ultrasonic pattern.

Magnetic Resonance found that adnexal left nodule, with heterogeneous signal pattern and significant contrast agent captation, suggestive of malignancy.

Serum Ca125 detected was 5 UI/ml.

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, that infiltrated less than 50% of myometrial wall found on Hysterectomy specimen. There was no lymphatic or omental metastases. FIGO staging IA, TNM staging T1aN0M0.

 

Conclusions

 

Sertoliform cystoadenoma is a very rare finding, with only few cases reported. It could be an estrogenic functioning tumour and due to this characteristic could induce endometrial hyperplasia, and at last, could be the reason for appearance of low malignancy degree endometrial neoplasms.

 

Related content

Poster
non-peer-reviewed

Can a Benign Ovarian Tumour develop a Malignant Endometrial Neoplasm? Sertoliform Ovarian Cystoadenoma getting together with a Low Malignancy Degree Endometrioid Adenocarcinoma G2


Author Information

Jose Martinez-Mas Corresponding Author

Obstetrics and Gynecology Department, Santa Lucía University Hospital, Cartagena, Murcia, Spain

Andres Bueno Crespo

Informatics Department, San Antonio Catholic University of Murcia (Spain)

Pedro J. Garcia Laencina

Informatics Department, University Center for Defence, Murcia

Juan Pedro Martinez-Cendan

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

Alejandra Isaac Montero

Pathologic Anatomy, University Hospital Santa Lucia

Asensio B. Garcia Nicolas

Obstetrics and Gynecology, University Hospital Santa Lucia

Manuel Remezal-Solano

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain


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  • Author Information
    Jose Martinez-Mas Corresponding Author

    Obstetrics and Gynecology Department, Santa Lucía University Hospital, Cartagena, Murcia, Spain

    Andres Bueno Crespo

    Informatics Department, San Antonio Catholic University of Murcia (Spain)

    Pedro J. Garcia Laencina

    Informatics Department, University Center for Defence, Murcia

    Juan Pedro Martinez-Cendan

    Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

    Alejandra Isaac Montero

    Pathologic Anatomy, University Hospital Santa Lucia

    Asensio B. Garcia Nicolas

    Obstetrics and Gynecology, University Hospital Santa Lucia

    Manuel Remezal-Solano

    Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

    Poster Information
    Meeting

    First International Online BioMedical Conference September 09, 2015 - September 12, 2015

    Publication history

    Received by Cureus: August 31, 2015
    Published: September 09, 2015

    License

    This is an open access poster distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction:

 

Sertoli cells tumours are neoplasms with a very low incidence, being sertoliform cystoadenomae extremely unusual. Its first description was made on 1982 by Young and Roth, with very few cases published after them. This is a neoplasm only described on postmenopausal women, with an average age of presentation of 68 year old, and they could suffer virilization symptoms in different degrees. Histologically, it is a well differentiated neoplasm, with a low malignancy degree, and good prognosis if it is confined to ovaries. In other way, the finding of this ovarian tumour getting together with an endometrioid adencarcinoma is an extremely rare case.

 

 

 

Medical Case:

 

A 66 year old woman, who attended our office relating postmenopausal metrorrhage, is presented. The patient had a medical history of diabetes mellitus type II, arterial hypertension, dyslipidemia, liver steatosis, glaucoma and appendectomy. She got three deliveries and had her menopause at the age of 53.

An outpatient hysteroscopy was carried on, finding three endometrial polyps, two of them appeared as normal, and the bigger one had a glandular appearance with atypical vascularization, taking biopsy of it that was informed as endometrioid type adenocarcinoma with mucus-secreting pattern.

Ultrasoud scanning found an adnexal left 2.5 cm nodule with heterogeneous ultrasonic pattern.

Magnetic Resonance found that adnexal left nodule, with heterogeneous signal pattern and significant contrast agent captation, suggestive of malignancy.

Serum Ca125 detected was 5 UI/ml.

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, that infiltrated less than 50% of myometrial wall found on Hysterectomy specimen. There was no lymphatic or omental metastases. FIGO staging IA, TNM staging T1aN0M0.

 

Conclusions

 

Sertoliform cystoadenoma is a very rare finding, with only few cases reported. It could be an estrogenic functioning tumour and due to this characteristic could induce endometrial hyperplasia, and at last, could be the reason for appearance of low malignancy degree endometrial neoplasms.

 

Jose Martinez-Mas

Obstetrics and Gynecology Department, Santa Lucía University Hospital, Cartagena, Murcia, Spain

For correspondence:
jomartmas@gmail.com

Andres Bueno Crespo

Informatics Department, San Antonio Catholic University of Murcia (Spain)

Pedro J. Garcia Laencina

Informatics Department, University Center for Defence, Murcia

Juan Pedro Martinez-Cendan

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

Alejandra Isaac Montero

Pathologic Anatomy, University Hospital Santa Lucia

Asensio B. Garcia Nicolas

Obstetrics and Gynecology, University Hospital Santa Lucia

Manuel Remezal-Solano

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

Jose Martinez-Mas

Obstetrics and Gynecology Department, Santa Lucía University Hospital, Cartagena, Murcia, Spain

For correspondence:
jomartmas@gmail.com

Andres Bueno Crespo

Informatics Department, San Antonio Catholic University of Murcia (Spain)

Pedro J. Garcia Laencina

Informatics Department, University Center for Defence, Murcia

Juan Pedro Martinez-Cendan

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

Alejandra Isaac Montero

Pathologic Anatomy, University Hospital Santa Lucia

Asensio B. Garcia Nicolas

Obstetrics and Gynecology, University Hospital Santa Lucia

Manuel Remezal-Solano

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

Jose Martinez-Mas

Obstetrics and Gynecology Department, Santa Lucía University Hospital, Cartagena, Murcia, Spain

For correspondence:
jomartmas@gmail.com

Andres Bueno Crespo

Informatics Department, San Antonio Catholic University of Murcia (Spain)

Pedro J. Garcia Laencina

Informatics Department, University Center for Defence, Murcia

Juan Pedro Martinez-Cendan

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

Alejandra Isaac Montero

Pathologic Anatomy, University Hospital Santa Lucia

Asensio B. Garcia Nicolas

Obstetrics and Gynecology, University Hospital Santa Lucia

Manuel Remezal-Solano

Obstetrics and Gynecology Department, Catholic University of Murcia (UCAM), Murcia, Spain

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