Abstract
Background: The ovarian tumors with functioning stroma are defined by the morphological presence of endocrine active cells in stroma, and the clinical, biochemical or pathological evidence of endocrine function. Case Report: The ovarian endometrioid adenocarcinoma with functioning stroma accompanied with endometrial endometrioid adenocarcinoma was found in 64-year-old post-menopausal woman complaining abnormal genital bleeding and mammary distention. Her preoperative serum 17?-estradiol level was high (53.2 pg/ml) while human chorionic gonadotropin (hCG) level was within normal limit. Her right ovary with 8.8 × 5.3 cm in size and tan-yellow in color mostly consisted of solid tumor. Histologically, tumor was composed of estrogen receptor (ER)- and progesterone receptor (PgR)-positive, and androgen receptor (AR)-negative cancerous endometrial cells with aggregates of vacuolated foamy stromal cells resembling luteinized cells. These stromal cells contained lipid droplets, and was immunopositive for α-inhibin and 17?-estradiol. After surgery, serum 17?-estradiol level decreased and became normal (14.2 pg/ml). These findings indicate the production of steroid hormone (17?-estradiol) from the foamy stromal cells and may be correlated with the clinical symptoms. Furthermore, ER- and PgR-positive endometrial endometrioid adenocarcinoma developed synchronously. However, ovary and uterus were totally immunonegative for human chorionic gonadotropin (hCG). Four other cases from the literature including ours are reviewed. Conclusion: Cancer cells were positive for ER and PgR in both ovary and uterus responded to steroid hormone produced by foamy stromal cells, which played a role in proliferation and progression of ovarian and endometrial endometrioid adenocarcinoma, respectively.
Highlights
The majority of ovarian cancer patients are diagnosed at an advanced stage because clinical symptoms such as abdominal swelling or genital bleeding appears in late stage, and that no symptoms are evident in the early disease stage [1]
As the frequency of endometrioid adenocarcinoma with functioning stroma is rare, we report an ovarian endometrioid adenocarcinoma with endocrinefunctioning stroma accompanied with endometrial endometrioid adenocarcinoma, which occurred in post-menopausal woman who complained abnormal genital bleeding and mammary distention for past 1 year
We reported a rare case of ovarian endometrioid adenocarcinoma with functioning foamy stromal cells accompanied with endometrial endometrioid adenocarcinoma
Summary
The majority of ovarian cancer patients are diagnosed at an advanced stage because clinical symptoms such as abdominal swelling or genital bleeding appears in late stage, and that no symptoms are evident in the early disease stage [1]. Case Report: The ovarian endometrioid adenocarcinoma with functioning stroma accompanied with endometrial endometrioid adenocarcinoma was found in 64-year-old post-menopausal woman complaining abnormal genital bleeding and mammary distention Her preoperative serum 17ß-estradiol level was high (53.2 pg/ml) while human chorionic gonadotropin (hCG) level was within normal limit. Tumor was composed of estrogen receptor (ER)- and progesterone receptor (PgR)-positive, and androgen receptor (AR)-negative cancerous endometrial cells with aggregates of vacuolated foamy stromal cells resembling luteinized cells. Conclusion: Cancer cells were positive for ER and PgR in both ovary and uterus responded to steroid hormone produced by foamy stromal cells, which played a role in proliferation and progression of ovarian and endometrial endometrioid adenocarcinoma, respectively
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