ovarian sclerosing stromal tumor
Introduction
Introduction to ovarian sclerosing stromal tumor Ovarian sclerosing stromal tumor is a rare ovarian cord stromal tumor, and ovarian sclerosing stromal tumor is a benign tumor. The cause is still unclear, but the number and structure of the chromosomes are abnormal, as well as the role of certain oncogenes and tumor suppressor genes. Since Scully first reported in 1973, there have been only a hundred cases reported in domestic and foreign literatures, which is a benign tumor mainly occurring in young women. basic knowledge The proportion of illness: 0.005% Susceptible people: women Mode of infection: non-infectious Complications: empyema
Cause
Ovarian sclerosing stromal tumor etiology
(1) Causes of the disease
The cause is still unclear, but the number and structural abnormalities of chromosomes have been found at the cellular level in genetics; at the molecular level, the effects of certain oncogenes and tumor suppressor genes have been discovered.
(two) pathogenesis
1. General examination of the tumor unilateral, nodular or lobulated, complete capsule, smooth surface, solid, tough, tumor diameter 1.5 ~ 17cm, mostly 6 ~ 7cm, cut surface solid, part of the braided, yellow White small foci, common edema, mucus change, cystic change, cystic cavity from honeycomb to several centimeters, the capsule is a slurry or mucus.
2. The structure of the tissue under the microscope is as follows:
(1) A nodule or pseudo-lobular structure is formed because the tumor is separated by collagen or edema fibrous connective tissue.
(2) The tumor cells vary in size and shape, and there are round, polygonal epithelioid cells, oval fibroblast-like cells and spindle cells. The tumor cells are mixed into nests, which are distributed in the nodules. Or within the false leaflets.
(3) Nests formed by tumor cells, which are rich in thin-walled blood vessels.
(4) Epithelioid tumor cells are round, kidney-shaped or fusiform, occasionally nucleoli, nuclear division 1/10HPFs, individual tumors up to 3 ~ 4/10HPFs, tumor cell cytoplasm transparent or vacuole, foam or granules It has the most diagnostic value of vacuolar cells with central nucleus and pituitary-like tumor cells with one nucleus on one side (Fig. 1).
(5) Part of the interstitial fibrosis glass is obvious.
3. Histochemical reticulum fiber staining showed that the reticulated fiber wrapped around single or several cells, the fat staining was mostly positive, and the mucus and PAS staining were negative.
Prevention
Ovarian sclerosing stromal tumor prevention
It is very important to maintain a good attitude, to maintain a good mood, to have an optimistic, open-minded spirit, and to be confident in the fight against disease. Don't be afraid, only in this way can you mobilize your subjective initiative and improve your body's immune function. Keep your mood steady and avoid emotional excitement and tension.
Complication
Ovarian sclerosing stromal tumor complications Complications
A small number of patients can have chest and ascites. When the pleural effusion is complicated, the large amount of liquid occupies the position of the chest, which makes the lung tissue compressively shrink, and chest pain and dyspnea can occur. The chest surface can be seen with a clear liquid level. When the effusion of the abdomen, the abdomen will have a significant increase, similar to the frog belly, mobile dullness is positive, B-ultrasound can be seen in the peritoneal effusion.
Symptom
Symptoms of ovarian sclerosing stromal tumors Common symptoms Hardening postmenopausal bleeding masculinization
Because tumor cells can secrete estrogen, androgen, clinical menstrual abnormalities caused by sex hormone disorders, primary or secondary infertility, postmenopausal bleeding, masculinization, plasma estrogen, testosterone, androstenedione Both dehydroepiandrosterones are elevated. Lifschitz et al. (1995) reported progesterone receptor-positive in the sclerosing nucleus of the sclerosing stromal cells and the glassy bodies of the tissues, which confirmed the endocrine function of the tumor. Symptoms are improved after tumor resection, and there are reports of postoperative pregnancy in infertile people.
In patients with large tumors, pelvic examination can touch the attachment of solid, smooth mass, tumors are often found in other abdominal surgery, or when routine ovarian biopsy is performed, the presence of microscopic tumors under the microscope is found.
Examine
Examination of ovarian sclerosing stromal tumors
Hormone level test, chest X-ray, B-mode ultrasound, histopathological examination.
Diagnosis
Diagnosis and differentiation of ovarian sclerosing stromal tumor
Because of the rare tumors, clinical diagnosis has certain difficulties. When young (under 30 years old) patients have solid smooth mass in the pelvic cavity, accompanied by infertility or menstrual disorders, the diagnosis should consider the possibility of ovarian sclerosing stromal tumor.
Differential diagnosis
Ovarian fibroma, vesicular cell tumor and sclerosing stromal tumor are solid tumors, but their age of onset is different. The former two occur mostly in middle-aged and elderly women before and after menopause, while the latter mostly occur in women of childbearing age under 30 years old. This will help in the clinical differential diagnosis of tumors.
Although most of the granulosa cell tumors occur after menopause, some of them occur in women of reproductive age, combined with similar clinical endocrine disorders, sometimes have certain difficulties in differential diagnosis, and more need to rely on pathological examination to confirm the diagnosis.
