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At least 19 recordsLinked to original sources

Review of the granulosa-theca cell tumors from the emil Novak ovarian tumor registry.

OBJECTIVE: Our purpose was to review patients with granulosa and theca cell tumors as filed in the Emil Novak Ovarian Tumor Registry. STUDY DESIGN: Our study was a descriptive, retrospective study of 454 case records. RESULTS: The reviewed diagnoses were for 97 patients with granulosa cell tumors, 116 with theca cell tumors, and 97 with granulosa-theca cell tumors. The remaining cases (n = 144) were reclassified as "nonspecific" gonadal stromal tumors (n = 61), luteomas of pregnancy (n = 7), and 76 "other" cases. These included poorly differentiated cancer, metastatic cancer, mixed mesodermal tumors, and sarcomas. The tumor-related mortality rate for the 310 patients with granulosa, theca, and granulosa-theca cell tumors was 7% (37.3% for granulosa cell tumors only). The surgical stage of disease was the most significant prognostic factor, with a mortality rate of at least 40%, given that the tumor had spread beyond the ovary. CONCLUSION: Because the differential diagnoses of particularly granulosa cell tumors included several conditions with an extremely poor prognosis, an accurate histologic diagnosis is crucial.

Diagnosis, Differential↗

Synchronous bilateral testis tumor: mixed germ cell and theca cell tumors.

Synchronous bilateral testis tumors of different histologic types are rare. All previous cases have demonstrated germ cell tumors on both sides. The simultaneous appearance of a germ cell tumor and a contralateral non-germ cell tumor has not been reported. We herein report a thirty-four-year-old man who presented with a mixed non-seminomatous germ cell tumor of the left testis and theca cell tumor of the right testis.

Adult↗

Partly luteinized theca cell tumor of the ovary.

The partly luteinized theca cell tumor is a variant of the theca cell tumor in which extensive foci of luteinization occur. This neoplasm belongs to a set of tumors, which includes the theca cell tumor, that is believed to be derived from mature ovarian stroma. This tumor can be classified as a tumor of specialized gonadal stroma of "ovarian cell type" intermediate between the theca cell tumor and the stromal luteoma. Two patients were virilized, and one had evidence of endometrial hyperplasia, whereas in the fourth no endocrine function was evident. None of the patients were pregnant at the time of discovery of the tumor. On gross examination these tumors consisted of a mixture of firm gray-white and yellow tissue. The presence of multiple yellow nodules in two tumors distinguished it from the usual theca cell tumor. A third tumor was distinctly lobulated. The tumor in only one of the cases arose in a background of ovarian stromal hyperplasia. Although the number of cases reported up to now is small and variability exists, the tumors tend to occur in patients in the early reproductive age group, often produce significant quantities of steroid hormones, and the clinical course has been benign.

Adolescent↗

[Endocrinological and clinico-pathologic study of granulosa-theca cell tumors of the ovary].

Nine granulosa-theca cell tumors (four pure theca cell tumors, one granulosa cell tumors, two granulosa-theca tumors and two juvenile granulosa-theca tumors) were studied endocrinologically and clinico-pathologically. The cases of juvenile granulosa-theca tumors developed precocious pseudopuberty. Three of seven other cases were re-feminized and four cases showed no hormonal manifestation clinically. The peripheral vein serum values of estradiol, progesterone, testosterone and prolactin were elevated in six of eight cases, three of four cases, four of six cases, and two of three cases, respectively. The concentration ratios between tumor harboring ovarian vein samples and peripheral vein (or opposite normal ovarian vein) samples was 2.7 to 16.9 for estrone, 8.8 to 28.6 for estradiol, 3.6 to 4.7 for progesterone, 1.6 to 6.6 for testosterone and 0.6 to 1.0 for prolactin. Estradiol was localized in both granulosa cells and theca cells, and testosterone was localized in granulosa cells in half of the cases and in theca cells in 60% of the cases. Also, testosterone was localized in all three cases in which luteinized theca cells were present. There were no cases with positive prolactin localization. These results are compatible with the concept that in granulosa-theca cell tumor, both granulosa and theca cells can produce a wide range of steroid hormones.

Aged↗

The fine structure of a virilizing human granulosa-theca cell tumor. Observations on the nature of the hormone producing cell.

The ultrastructure of a virilizing granulosa-theca cell tumor is reported. Although the histologic appearance is characteristic of a granulosa-theca tumor, several tumor cells contain crystalloids of Reinke which have not been associated with sex-cord-stromal tumors, but which are often present in ovarian hilus cells and Leydig cells. The steroidogenic cell in this case displays many fine structural features common to mammalian steroidogenic cells, namely abundant smooth endoplasmic reticulum, a dispersed Golgi, mitochondria with tubular cristae, and lipid droplets. Other features of this cell, which contains crystalloids of Reinke, more closely resemble those of a theca-lutein cell than a granulose-lutein or hilus cell and support a stromal origin. However, this tumor illustrates the striking overlap in morphologic features and function among granulosa, theca, hilus, and Leydig cells.

Adult↗

Clinicopathologic review of 118 granulosa and 82 theca cell tumors.

The clinical course and histologic features of 118 granulosa cell tumors and 82 theca cell tumors were reviewed. Although the 2 cell types are related, important differences exist in their behavior. Theca cell tumors (TCTs) are virtually benign, while granulosa cell tumors (GCTs) exhibit less malignant activity than most ovarian carcinomas. Characteristically detected at an early stage, GCTs may recur locally years after the initial diagnosis. Survival figures depend on tumor stage. Recurrence of GCTs is associated with a high mortality rate. The cornerstone of treatment is total abdominal hysterectomy and bilateral salpingo-oophorectomy, regardless of age. Adjuvant radiation or chemotherapy may be helpful when lesions are higher than stage lai. Therapy for recurrence usually requires operative excision combined with radiation, chemotherapy, or both.

Adolescent↗

Granulosa and theca cell tumors in children: a report of 17 cases and literature review.

The files of the Emil Novak Ovarian Tumor Registry (ENOTR) were searched for granulosa and theca cell tumors in children aged 12 years and less. In addition, an extensive literature search was done for English publications on children with these tumors aged 10 years or less. Of the 17 children from the ENOTR, 5 had adult-type granulosa cell tumors, 6 had juvenile granulosa cell tumors, and 1 had a luteinized granulosa cell tumor. In addition, there were three cases with gonadal stomal tumors, one theca cell tumor, and one granulosa-theca cell tumor. Precocious pseudopuberty was present in 70 percent of the children, abdominal pain in 24 percent, and ascites in 18 percent. The literature review revealed a tumor-related mortality rate of 9 percent (based on 163 cases with granulosa cell tumors, including the juvenile type). Some of these tumors are large with acute pain, but nevertheless, the prognosis is good, particularly in cases with precocious puberty. Treatment can be conservative.

Adolescent↗

[Morphological and endocrinological study of theca cell tumor during pregnancy].

With a theca cell tumor of the ovary associated with pregnancy, an extremely rare occurrence in a 30 years old primigravida at 15 weeks of gestation, morphological and endocrinological studies were performed. The tumor was composed of cell-nests scattered among a fibromatous structure. The round or polygonal cells are rich in eosinophilic cytoplasm, resembling theca internal cells. The histochemical activity of 3 beta-HSD and G-6-PDH was demonstrated in these cells. They had the ultrastructures characteristic for steroid-producing cells, in some of which immature and mature Reinke crystalloid-like structures were identified. Mature ones were infrequently observed in contrast to the numerous immature ones. It is considered that a few cells might have differentiated into Leydig cells in the course of differentiation into thecomatous cells from ovarian stroma or mesenchyme. Judged from the rapid enlargement in early pregnancy, this tumor may depend on hCG. Serum estradiol was decreased immediately after removal of the tumor even at 15 weeks of gestation. Histochemical, ultrastructural and endocrinological findings suggest that the tumor was secreting mainly estradiol at the time of the operation.

3-Hydroxysteroid Dehydrogenases↗

Malignant theca cell tumor of rat.

A large-sized ovarian tumor of theca cell origin was found in a female rat. The mass was located in the right ovary position. Histologically, the tumor was covered by thin fibrous capsule and consisted of a solid area and an abundant necrotic area. Tumor cells were arranged in a storiform or whorled pattern. Connective tissue elements occasionally presented as bundles of dense collagen fibers. Fusiform to elongated cells had oval- to spindle-shaped nuclei with indistinct nucleoli. Large round nuclei and mitotic figures were scattered throughout the tumor cells. These cells were stained positively with S-100 but negatively with vimentin and a-smooth muscle actin. Tumor cells with abundant cytoplasm sometimes contained multiple small-sized lipid vacuoles.

Animals↗

Granulosa-theca cell tumor associated with an ovulation fossa and normal ovarian stroma in a mare.

A granulosa-theca cell tumor was found in an ovary that had an ovulation fossa and normal ovarian tissue. The ovary was removed from a mare with a history of ovarian enlargement and behavioral changes. The affected ovary had a multicystic appearance on ultrasonographic examination performed before surgery, and an ovulation fossa was not palpable on examination per rectum. However, during surgery, the affected ovary was found to be within normal size limits, with an enlargement on 1 pole, and to contain an ovulation fossa. Atrophy of the infundibulum of the affected ovary helped to confirm the diagnosis of granulosa-theca cell tumor, and the ovary was removed. The mare's testosterone concentrations were normal. Granulosa-theca cell tumors are usually associated with a spherical ovary, attributable to ablation of the ovulation fossa, with no normal ovarian tissue present.

Animals↗

Granulosa-cell and theca-cell tumors. The clinical picture and long-term outcome for the Radiumhemmet series.

Over the period 1923--72 a total of 305 patients with granulosa-cell, theca-cell tumor and mixed tumor were seen at Radiumhemmet. The commonest symptom was abnormal uterine bleeding. Twenty-three per cent of married women were nulliparous. The menarche seems to have occurred earlier in this group than in the general population. Eight of the granulosa-cell tumor group gave birth to 12 children after treatment for the tumor. Nineteen women with granulosa-cell tumor and 4 with thecoma had received radiotherapy earlier in life for benign lesions. The risk of endometrial cancer was approximately 10 times greater for the women with granulosa- or theca-cell tumor than for the general population. Two hundred and fifty-two patients were given both surgical treatment and radiotherapy. Fifty-three received only surgery (37 granulosa-cell and 16 theca-cell tumors). None of the thecoma patients but 21 per cent of those with granulosa-cell tumor died from their disease. The 5-year survival for the latter group, all stages, was 85 per cent.

Adolescent↗