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 Reproductive Riddle  



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Author10 Posts
  #1



A 54-year-old woman goes to her obstetrician for her annual pelvic examination. Her last menstrual period was 5 years ago, and she denies any medical problems, including flushing, vaginal bleeding, or changes in weight. On physical examination, the obstetrician palpates a right adnexal mass. Ultrasonographic evaluation confirms the presence of a solid mass in the right ovary. The ovary is removed and sent to pathology. A portion of the pathology report reads as follows: "7.2cm well-encapsulated white mass with no hemorrhagic components. A few cystic areas are also evident. Histologic evaluation demonstrates numerous spindle-shaped cells with interspersed lipid-laden cells."


Which of the following is the most likely diagnosis?



(A) Androblastoma

(B) Brenner tumor

(C) Dysgerminoma

(D) Endometrioid carcinoma

(E) Fibrothecoma








  #2

Brenner? Not sure


  #3

shocked Wht 46 views n only one response disapprovaldisapproval
No Epica its not Brenner's


  #4

A. sticking out tongue And don't talk to me!





  #5

Wrong Again Buddy


  #6

I will Wait for one More Courageous Person to Answer this Question or Atleast try to do it
raised eyebrow




  #7

(E) Fibrothecoma



  #8

E


  #9

I wanted to say it before but clinical picture was not so clear, but it"s probably Fibrotec.
She is old for Dysgerminoma


  #10

Choice A: An androblastoma is a Sertoli-Leydig cell tumor. These commonly produce androgens and cause virilization. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />



Choice B: A Brenner tumor is also uncommon, occurring in the older age group. Mucin-containing cysts are often seen. Microscopically there is a fibroblastic stroma with additional nests of cells that resemble transitional epithelium.



Choice C: A dysgerminoma occurs in the younger population (10-30 year old). Germ cells with fibrous septa are noted microscopically.



Choice D;Endometrioid carcinomas make up about 1/5 of malignant ovarian neoplasms. They are distinct from, but often occur with, endometriosis. The tumor has the appearance of uterine endometrium.



Choice E: CORRECT: Fibrothecomas are relatively uncommon benign ovarian neoplasms, seen primarily in postmenopausal women. As the name indicates, the tumor is composed primarily of fibroblasts with a few interspersed lipid-rich thecal cells. These solid-appearing tumors, which can grow up to 15-20 cm in size, are usually unilateral. In 20-40% of cases, such tumors are associated with abdominal ascites in the triad of ovarian neoplasm, ascites, and pleural effusions (Meigs syndrome). Once the neoplasm is removed, the ascites and pleural effusion resolves.






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