Abstract
IntroductionSteroid cell tumors are microscopically characterized by abundant eosinophilic or vacuolated cytoplasm that is often positive for fat stains. These tumors could be of ovarian or ectopic adrenal origin. We present a rare case of a steroid cell tumor arising from the pelvic mesentery.Case presentationA 31-year-old Asian woman was undergoing treatment for infertility and virilizing symptoms. She underwent laparoscopy followed by laprotomy for a suspected ovarian cyst/pelvic mass. During the laprotomy, a mass of 9 × 7 cm was detected in the pelvic mesentery.Microscopically, the tumor showed large cells arranged predominantly in sheets with abundant granular cytoplasm and large vesicular nuclei with prominent nucleoli. The tumor was seen infiltrating surrounding adipose tissue. Immunohistochemically, the tumor cells showed strong positivity for kertain, inhibin, vimentine, melan-A, neuron-specific enolase, chromogranin, and S-100 protein and focal positivity to epithelial membrane antigen. An MIB1 index showed 4% nuclear positivity. The tumor cells were negative for calretinin, desmin, and muscle actin. Considering the clinical findings, histomorphology, and immunohistochemistry, we made the diagnosis of extraovarian and extra-adrenal steroid cell tumor (not otherwise specified) of the pelvic mesentery.ConclusionsWe report an extremely rare case of an extraovarian and extra-adrenal steroid cell tumor of the pelvic mesentery. The tumor was a cause of virilizing symptoms and infertility in the patient. Surgical removal of the tumor reverted the symptoms of virilization, and the patient subsequently conceived. Steroid cell tumors should be considered in differential diagnosis among women presenting with infertility and symptoms of virilization.
Highlights
Steroid cell tumors are microscopically characterized by abundant eosinophilic or vacuolated cytoplasm that is often positive for fat stains
Steroid cell tumors should be considered in differential diagnosis among women presenting with infertility and symptoms of virilization
The majority of them produce steroids, testosterone, and present with virilizing symptoms such as hirsutism, temporal balding, and amenorrhea [2,3,4,5]. They have been divided into three subtypes according to their cell of origin: stromal luteoma arising from ovarian stroma, Leydig cell tumor arising from Leydig cells in the hilus, and steroid cell tumor when the lineage of the tumor is unknown [1,2]
Summary
The present case was a rare report of an extraovarian and extra-adrenal steroid cell tumor of the pelvic mesentery. The tumor was a cause of virilizing symptoms and infertility in our patient. Surgical removal of the tumor reverted the symptoms of virilization, and our patient subsequently conceived. Steroid cell tumors should be considered in differential diagnosis among women presenting with infertility and symptoms of virilization. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Authors’ contributions KM helped to make the histopathological and immunohistochemical diagnosis, conceived the study, and helped to prepare the manuscript. RL worked up the clinical details and helped to prepare the manuscript. UM helped to make the histopathological and immunohistochemical diagnosis. All authors read and approved the final manuscript.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
