Follikuloma - folliculoma
Endocrinology / / August 12, 2017
Tumors of the elements of the female gonads
(feminizing ovarian tumors) By feminizing ovarian tumors include granulosa tumors, and tumors of mixed TECOM buildings - granulosa-theca tumors.This group of ovarian cancer combined both on the basis of clinical manifestations related to their hormonal activity, and the nature of the morphological structure of the tumor, which are also found in normal ovary.
granulosa tumor - Follikuloma
granulosa tumor mostly unilateral and have a different value from the value of a pea to a newborn baby's head, and even to an enormous size, occupying the whole pelvic cavity.However, the tumor size is not important for the development of clinical manifestations of feminizing action.Thus, children are small tumors (less than a walnut) produce a clear picture of precocious puberty.Consistency solid tumor or elastic surface is smooth, bumpy.In the context of the tumor has a dense solid areas, and small- and large-cystic areas.Histological tumor structure may r
Figure: Patient 5 years.Diagnosis: follikuloma ovary.
and - well-marked signs of precocious puberty;
b - Remote follikuloma ovary in the same patient;
in - histology of the removed tumor from the same patient.Bands diffusely located granulosa cells.Smears tumor is reminiscent of the structure of normal follicular granulosa cells.
In the literature there are indications that these tumors occur in 10% of cases in relation to all ovarian tumors.
granulosa tumors occur at any age, even in infancy, but their frequency increases at age 40 years and older.At menopause falls about 50% of all diseases.Clinical symptoms depend on the age of the patient.At an early age, there are signs of precocious puberty: develop secondary sex characteristics (growth of breasts and body hair on the female type), increasing the size of the uterus and vagina, appear uterine bleeding.The growth and skeletal development far exceed the actual age (see figure), but the development of intelligence remains a child.
The reproductive period of a woman's life in the presence of a tumor there are various menstrual disorders, often the type menometrorrhagias, less delay menstruation and amenorrhea.
in menopause and after menopause often observed uterine bleeding, then periodically aggravated, it stops on its own.In patients with menopausal and postmenopausal age with granulosa tumor, usually no age youthful appearance, good turgor of tissues of the body and there is no age atrophy of reproductive organs.
Despite the characteristic symptoms, the disease remains undiagnosed for several years.In children, the disease is detected before menopause.
granulosa tumors can be either benign or malignant course.
In recent years, accumulated a lot of evidence that ovarian granulosa tumors often undergo malignant transformation.Relapses occur late: from 5 to 15 years after surgery.
- hormone producing tumors of the ovaries
- ovarian anatomy
- ovarian hormones.Androgens
- menstrual cycle
- Hormonal disorders of the menstrual cycle
- tests of functional diagnostics of ovarian activity
- Violation monthly rate.Amenorrhea
- Violation of the menstrual cycle with monthly rhythm disorder.Opsomenoreya
- Violation of the menstrual cycle with monthly rhythm disorder.Polimenoreya
- principles of hormone therapy violations
- menstrual Principles of hormonal treatment of dysfunctional uterine bleeding
- Prevention of recurrence of dysfunctional uterine bleeding
- polycystic ovarian degeneration (syndrome Stein - Leventhal)
- Violation bleeding intensity in the menstrual cycle.Dysfunctional uterine bleeding.
Treatment of ovarian granulosa tumors surgery alone.The issue of radical surgical treatment is still debated.Some authors insist on radical surgery as a hysterectomy and appendages, given the high percentage of malignancy.Most of them share the need for bilateral removal of the appendages and uterus due to frequent bilateral lesions (even if it is unnoticed macroscopically) and the possibility of recurrence of the disease.
question of hysterectomy should be decided individually.In the more elderly group of patients the uterus to be removed or at least supravaginal amputation.However, if the disease in younger women, in some cases it is difficult to decide on the removal of both ovaries, especially if the tumor is a benign ovarian, and the second is not changed.