Evidence of Spontaneous Recovery of Granulosa-Theca Cell Tumour in a Heifer: A Retrospective Report
Evidence of Spontaneous Recovery of Granulosa-Theca Cell Tumour in a Heifer: A Retrospective Report
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DOI：
10.1111/rda.12555
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发表时间：
2015-08-01
影响因子：
1.7
通讯作者：
Osawa, T.
中科院分区：
文献类型：
--
作者：
Ali, H. El-Sheikh;Kitahara, G.;Osawa, T.
内容在第0天（D 0）评价14月龄日本黑小母牛的右侧卵巢（RO）增大。经直肠超音波检查显示RO明显增大且多囊，而左侧卵巢（LO）较小且无活性。初步诊断为颗粒膜细胞瘤（GTCT），并通过血浆抗苗勒管激素（AMH）显著升高（4.42 ng/ml）予以证实。因此，RO的卵巢切除术是治疗的选择。在D42、D 63和D85卵巢切除术前即刻，通过TRUS检查小母牛并采血。与D 0相比，D42时TRUS显示任一卵巢均无明显变化。然而，在D 63，RO已转化为一个单一的囊肿，并在D85，LO已恢复周期活动。在第85天通过手助腹腔镜卵巢切除术取出RO，以便更好地控制。出乎意料的是，组织病理学显示病变是充满液体的囊性结构，没有提示GTCT的滤泡上皮肿瘤性增生。囊壁由胶原纤维和少量退化的颗粒细胞组成。回顾性激素分析显示，AMH浓度在D 63和85时显著下降，这与LO中周期性的恢复相一致。这些结果表明，GTCT已经自愈并转化为囊肿样结构。然后在D105对小母牛进行发情同步化方案，在D115进行人工授精并妊娠。
Contents A 14-month-old Japanese Black heifer was evaluated on Day 0 (D 0) for enlargement of the right ovary (RO). Transrectal ultrasonography (TRUS) revealed that the RO was markedly enlarged and multicystic, while the left ovary (LO) was small and inactive. The presumptive diagnosis was granulosa-theca cell tumour (GTCT), which was confirmed by markedly elevated plasma anti-Mullerian hormone (AMH) of 4.42ng/ml. Therefore, ovariectomy of the RO was the treatment of choice. The heifer was checked by TRUS and blood sampling on D 42, D 63 and immediately before ovariectomy on D 85. On D 42, TRUS did not show marked changes in either ovary in comparison with D 0. However, on D 63, the RO had transformed into a single cyst, and on D 85, the LO had resumed cyclic activity. The RO was extracted on D 85 by hand-assisted laparoscopic ovariectomy to allow better control. Unexpectedly, histopathology revealed the lesion to be a fluid-filled cystic structure, with no neoplastic proliferation of follicular epithelium that would indicate GTCT. The wall of the cystic structure consisted of collagen fibres and a few degenerated granulosa cells. The retrospective hormonal analysis revealed that the AMH concentrations had markedly dropped on D 63 and 85, which coincided with resumption of cyclicity in the LO. These findings suggest that the GTCT had self-cured and transformed into a cyst-like structure. The heifer then received an oestrous synchronization regime on D 105, was artificially inseminated on D 115 and became pregnant.