Thecoma is a rare and almost invariably benign ovarian sex-cord stromal tumor that is predominantly diagnosed in postmenopausal women. In this patient group, an asymptomatic course is frequently observed. Hormone-secreting thecomas are, however, more frequent among younger women and associated with uterine bleeding, abdominal distension, and pain. Clinical findings and imaging studies are needed to make the diagnosis, but the exact tumor type is often determined postoperatively.
The ovarian tumor thecoma belongs to a group of sex-cord stromal tumors, and the name stems from its lipid-rich stromal cells that are strikingly similar to theca cells located in the ovarian follicles   . Thecoma is virtually always a benign tumor (although rare malignant cases have been reported), and it is principally diagnosed in postmenopausal women  . The clinical presentation depends on whether the tumor contains cells that produce steroid hormones (termed luteinized thecoma) or not (typical and rarely calcified thecoma)  . Luteinized thecoma has been shown to appear at a slightly younger age and may produce estrogenic, virilizing, or mixed effects   . Non-secreting tumors rarely cause symptoms. Certain authors report that more than 60% of post-menopausal women are asymptomatic . Tumors that synthesize estrogen, on the other hand, produce symptoms such as uterine bleeding (and menstrual irregularities in younger women), abdominal pain and/or distension, whereas an abdominal mass might be identified during a physical examination  . In addition, between 20-50% of cases suffer from concomitant endometrial carcinoma   . Although they can present with worrying symptoms, the clinical course of thecoma is benign and proper surgical treatment results in a cure .
In contrast to other virilizing ovarian tumors, which present as rapidly progressive hirsutism, ovarian thecoma (like hilus cell tumors of ovary) can present as slowly progressive hirsutism. 1. Carmina E, Rosato F, Jannì A, Rizzo M, Longo RA. [ijem.in]
Although laser treatment helped with her hirsutism, her other virilizing symptoms (deepening of voice, clitoromegaly) did not improve postoperatively. [ncbi.nlm.nih.gov]
Keywords Thecoma, pregnancy, hirsutism, Virilism About this article Keywords Thecoma pregnancy hirsutism Virilism Authors Małgorzata Kogut Jarosław Janeczko Małgorzata Trzcińska Marek Grzywa [journals.viamedica.pl]
Physical examination showed hirsutism of her face and body, a deep voice, acne on her face, and enlargement of the clitoris. However, she had no features suspected Cushing syndrome. [eymj.org]
- Testicular Swelling
He presented with left testicular swelling and underwent a radical orchiectomy on suspicion of a malignant paratesticular tumor. The tumor arose from the testis exophytically and was diagnosed as a thecoma histopathologically. [ncbi.nlm.nih.gov]
- Testicular Mass
Definition / general Rare, benign behavior Ages 21 - 74 years, painless testicular masses Sex cord stromal tumors composed of spindle, oval or round cells producing collagen Cellular fibromas have scanty collagen Terminology Synonyms: Benign gonadal stromal [pathologyoutlines.com]
The presence of abnormal uterine bleeding or menstrual abnormalities should prompt the physician to perform a meticulous clinical and imaging workup. Firstly, a detailed patient history including the onset of symptoms and their progression must be noted, followed by a complete physical examination, with an emphasis on abdominal and pelvic inspection/palpation. As soon as initial suspicion is raised, imaging studies should be employed. Abdominal ultrasonography (US) is a highly useful initial method in the evaluation of abdominal pathologies. The presence of a unilateral adnexal hypoechoic mass possessing clear borders and a weak vascular signal on Doppler imaging are hallmarks of a thecoma . To confirm the diagnosis, however, more advanced studies - computed tomography (CT) and magnetic resonance imaging (MRI), are often necessary. CT shows an isodense or hypodense tumor, whereas isointense signaling on T1- weighted images and either hypointense or isointense signaling T2- weighted images are typical findings (although some authors claim that even hyperintense signals can be encountered on T2, depending on the amount of surrounding edema)     . In addition to imaging procedures, the use of ovarian serum tumor marker (CA 125) in the diagnostic workup might also be recommended, as it is frequently elevated in the presence of a neoplastic process in the ovaries  .
Diagnosis and treatment of ovarian thecoma occurring during pregnancy are discussed with relevant references. [ncbi.nlm.nih.gov]
Prognosis With early detection and treatment the prognosis for thecoma is quite good. [knowcancer.com]
Prevention, and Complications Very poor prognosis up to 70% of women present at stage III or I V prognosis is strongly associated with the stag e at diagnosis USPSTF recommends against routine screening for ovarian cancer In women with familial BRCA [medbullets.com]
LM bland oval or spindled nuclei, abundant cytoplasm that is pale and vaculolated LM DDx ovarian fibroma, fibroma-thecoma IHC alpha-inhibin +ve Gross solid yellow mass, usually well-circumscribed Site ovary - see ovarian tumours Prevalence uncommon Prognosis [librepathology.org]
Treatment and prognosis Thecomas are almost always benign and have low malignant potential, although there have been isolated reports of malignant thecomas. fibroma low signal on T2 given the fibroid content less enhancement adult granulosa cell tumor [radiopaedia.org]
The occurrence of an extremely rare testicular thecoma in this case (the second in the literature) suggests that such an etiological association may also exist in the pathogenesis of testicular tumors. [ncbi.nlm.nih.gov]
[…] blood CF cerebrospinal fluid CI chemically induced CH chemistry CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology [decs.bvs.br]
Association of these two conditions is extremely rare and the etiology currently remains unclear. [scielo.br]
English : BS blood supply BL blood CF cerebrospinal fluid CI chemically induced CH chemistry CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
[…] with epithelial differentiation Stromal tumor resembling fibroma Testicular fibroma Testicular stromal tumor with myofilaments Theca cell tumor Thecoma-like Sertoli cell tumor Unclassified sex cord stromal tumor with a predominance of spindle cells Epidemiology [pathologyoutlines.com]
Sertoli–Leydig cell tumor group Epidemiology Sertoli-Leydig cell tumors are uncommon benign tumors, accounting for less than 0.5% of all ovarian tumors. [emedicine.medscape.com]
Epidemiology Benign ovarian tumours occur in 30% of females with regular menses (eg, luteal cysts as incidental findings on pelvic scans) and 50% of females with irregular menses. [patient.info]
Defining the functional effects of TTN truncating mutations should improve our understanding of the pathophysiology of dilated cardiomyopathy. (Funded by the Howard Hughes Medical Institute and others.) [nejm.org]
Different kinases can modify the TTN elasticity in different ways; indeed, it is known that changes in post-translational modification (in particular hypophosphorylation) plays a role in the pathophysiology of heart disease ( 13 ). [frontiersin.org]
Awareness of this newly described condition, which may be more common than previously thought, may help prevent further misdiagnosis. [ncbi.nlm.nih.gov]
[…] diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology GE genetics HI history IM immunology ME metabolism MI microbiology MO mortality NU nursing PS parasitology PA pathology PP physiopathology PC prevention [decs.bvs.br]
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[…] removal of pelvic and para-aortic lymph nodes and omentum Chemotherapy combination of platinum (i.e. carboplatin) and non-platinum (i.e. paclitaxel) regimen Radiation reserved for palliation or localized persistent disease after chemotherapy Prognosis, Prevention [medbullets.com]
Problems associated with all of these are mostly preventable. Change the company law Part of the problem of doing business in Thailand is that, no matter how good you are, you never really own the legal framework that defines your business. [thethaiger.com]
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