Ovarian epithelial carcinoma with estrogen-producing stroma
Ovarian epithelial carcinoma with estrogen-producing stroma
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DOI：
10.1111/j.1440-1827.2007.02099.x
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发表时间：
2007-05-01
影响因子：
2.2
通讯作者：
Yaegashi, Nobuo
中科院分区：
文献类型：
--
作者：
Tokunaga, Hideki;Akahira, Jun-ichi;Yaegashi, Nobuo
产生雌激素的卵巢上皮来源的恶性卵巢肿瘤在绝经后妇女中很少见。本文报告一位81岁女性右侧卵巢IC(A)期子宫内膜样腺癌，主诉乳房压痛、疼痛及不典型生殖器出血。治疗前血清雌二醇(E-2)浓度为83pg/m L，经阴道超声测量子宫内膜厚度为5 cm，远高于80多岁女性的预期厚度。手术后，她的主诉消失，她的血清E-2水平下降到绝经后的正常水平。免疫组织化学研究表明，肿瘤中存在产生雌激素所需的酶。免疫组织化学数据表明，这种上皮性卵巢癌可以通过癌细胞和间质细胞之间的潜在相互作用自行产生雌二醇，患者血清中高水平的雌二醇是由肿瘤内产生的。本病例提示，除了间质肿瘤，如颗粒细胞瘤、卵泡膜细胞瘤、腺纤维瘤等外，在评估老年卵巢肿瘤时，还应考虑间质功能正常的恶性上皮性肿瘤。
Malignant ovarian neoplasms derived from ovarian epithelium that produce estrogen are rare among postmenopausal women. Presented herein is a case of stage Ic(a) endometrioid adenocarcinoma in the right ovary of an 81-year-old woman, who complained of mammary tenderness, pain and atypical genital bleeding. Her serum estradiol (E-2) concentration was 83 pg/mL before treatment, and the endometrial thickness measured by transvaginal ultrasonography was 5 cm, much thicker than that expected for a woman in her 80s. After surgery, her complaints disappeared and her serum E-2 level decreased to normal postmenopausal levels. Immunohistochemical studies demonstrated that the enzymes required to produce estrogen were present in the tumor. Immunohistological data indicated that this epithelial ovarian cancer could produce estradiol by itself, through potential interactions between cancer cells and stromal cells, and that the high level of estradiol in the patient's serum was caused by intratumoral production. This case indicates that in addition to stromal tumors, such as granulosa cell tumors, theca cell tumors, adenofibroma and so on, malignant epithelial tumors with a functioning stroma should also be considered when evaluating ovarian tumors with estrogen production in the elderly.