Obstet Gynecol Sci.  2013 Jan;56(1):50-55. 10.5468/OGS.2013.56.1.50.

An asymptomatic ovarian steroid cell tumor with complete cystic morphology: A case report

• Chun YJ
• Choi HJ
• Lee HN
• Cho S
• Choi JH

• KMID: 1857187
• DOI: http://doi.org/10.5468/OGS.2013.56.1.50

Abstract

Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. Of these, steroid cell tumors, not otherwise specified (NOS) constitute about 56% of all steroid cell tumors. Most steroid cell tumors secrete steroid hormones, and only about 10% to 15% of patients are asymptomatic. The morphology of steroid cell tumors, NOS is predominantly reported to be solid, and a review of case reports from 1979 until now revealed only 5 cases that were mainly cystic tumors. The present case, in a patient who had undergone a previous hysterectomy and surgery for a peritoneal inclusion cyst, is reported due to its rarity and its unusual presentation, together with a brief review of the literature. The tumor showed no clinical signs and symptoms typical of a steroid hormone secreting tumor and had an atypical morphology, being primarily multi-septate cystic with a minor solid portion.

Keyword

Steroid cell tumor; Ovary; Cystic

MeSH Terms

Accounting
Female
Humans
Hysterectomy
Ovary

Figure

• 

  Fig. 1 Transvaginal ultrasound indicating a large 10×8×7 cm3 sized cystic mass at the center of the pelvic cavity, with internal septation and no apparent solid portion.

• 

  Fig. 2 An abdominopelvic computed tomographic scan after enhancement shows a 10×8 cm sized cystic mass in the left ovary, with internal septation (arrow) and a solid portion (arrowhead), which is enhanced by contrast media.

• 

  Fig. 3 (A) Histological specimen shows large aggregates of tumor cells with abundant eosinophilic to clear cytoplasm, with a granular appearance and vacuolization (H&E, ×200). (B) Immunohistochemical staining shows the tumor cells exhibiting a diffuse positive reaction for inhibin (brown) (×200). (C) Immunohistochemical staining shows a diffuse positive reaction of the tumor cells for calretinin (dark red) (×100).

Reference

1. Young RH. Kurman RJ, Ellenson LH, Ronnett BM, editors. Sex cord-stromal, steroid cell, and other ovarian tumors with endocrine, paraendocrine, and paraneoplastic manifestations. Blaustein's pathology of the female genital tract. 2011. 6th ed. Boston (MA): Springer;785–846.

2. Hayes MC, Scully RE. Ovarian steroid cell tumors (not otherwise specified). A clinicopathological analysis of 63 cases. Am J Surg Pathol. 1987. 11:835–845.

3. Gershenson DM, Hartmann LC, Young RH. Barakat RR, editor. Ovarian sex cord-stromal tumors. Principles and practice of gynecologic oncology. 2009. 5th ed. Philadelphia (PA): Lippencott;855–874.

4. Baloglu A, Bezircioglu I, Cetinkaya B, Karci L, Bicer M. Development of secondary ovarian lesions after hysterectomy without oophorectomy versus unilateral oophorectomy for benign conditions: a retrospective analysis of patients during a nine-year period of observation. Clin Exp Obstet Gynecol. 2010. 37:299–302.

5. Taylor HB, Norris HJ. Lipid cell tumors of the ovary. Cancer. 1967. 20:1953–1962.

6. Deavers MT, Malpica A, Ordonez NG, Silva EG. Ovarian steroid cell tumors: an immunohistochemical study including a comparison of calretinin with inhibin. Int J Gynecol Pathol. 2003. 22:162–167.

7. Young RH, Shully RE. Haines M, Taylor CW, Fox H, Wells M, editors. Steroid cell tumors of the ovary. Haines and Tayler obstetrical and gynaecological pathology. 2003. 5th ed. Edinburgh: Churchill Livingstone;845–856.

8. Wang PH, Chao HT, Lee RC, Lai CR, Lee WL, Kwok CF, et al. Steroid cell tumors of the ovary: clinical, ultrasonic, and MRI diagnosis: a case report. Eur J Radiol. 1998. 26:269–273.

9. Wang PH, Chao HT, Liu RS, Cho YH, Ng HT, Yuan CC. Diagnosis and localization of testosterone-producing ovarian tumors: imaging or biochemical evaluation. Gynecol Oncol. 2001. 83:596–598.

10. Sakamoto K, Fujimitsu R, Ida M, Horiuchi S, Hamada Y, Yoshimitsu K. MR diagnosis of steroid cell tumor of the ovary: value of chemical shift imaging. Magn Reson Med Sci. 2009. 8:193–195.

11. Wang PH, Chao HT, Lee WL. Use of a long-acting gonadotropin-releasing hormone agonist for treatment of steroid cell tumors of the ovary. Fertil Steril. 1998. 69:353–355.

12. Bernasconi D, Del Monte P, Marinaro E, Marugo A, Marugo M. Severe postmenopausal hyperandrogenism due to an ovarian lipoid cell tumor: a case report. Minerva Endocrinol. 2004. 29:25–29.

13. Cserepes E, Szucs N, Patkos P, Csapo Z, Molnar F, Toth M, et al. Ovarian steroid cell tumor and a contralateral ovarian thecoma in a postmenopausal woman with severe hyperandrogenism. Gynecol Endocrinol. 2002. 16:213–216.

14. Kim YT, Kim SW, Yoon BS, Kim SH, Kim JH, Kim JW, et al. An ovarian steroid cell tumor causing virilization and massive ascites. Yonsei Med J. 2007. 48:142–146.