Tumors of the elements of the female gonads ( feminizing ovarian tumors)
Endocrinology / / August 12, 2017
Tumors of the male elements of the female gonads (arrhenoblastoma) were first described by Mayer (the Meyer) in 1930-1931., The author singled out this group of tumors due to masculinizing effects on the body of the patient.In the future, a number of works allowed to differentiate the whole group omuzhestvlyayuschih tumors both in the clinical picture and on the histological structure of their elements.
By the nature of histologic patterns and clinical manifestations of tumors with heterosexual activity are divided into:
1. androblastoma, which include:
b) hilyusa tumor cells;
2. Mixed tumor.
tumor is located in the cortical layer of the ovary or in the ovary gate, pushing the ovarian tissue that almost always remains, even with large amounts of tumor.The tumor has a smooth or lumpy structure.In the section, it is a solid, homogeneous or has a lobed structure with small cystic cavities filled with serous fluid.Histo
between trabeculae forming a network structure, located in the stroma leydigovy interstitial cells, and the presence of which is attributed to virilizing effect.
most undifferentiated form of solid tumors, similar to the stroma due to the absence of the epithelial component.In some cases the histology of the tumor resembles tekomu since the tumor is made up of strands of spindle cells.
undifferentiated tumors structure virilizing have a more pronounced effect, while differentiated tumors may have a poorly defined masculinizing effects and feminizing effect.These data indicate that the cells lining the tubular structure of the tumor (Sertoli like), do not produce androgens, while the clinical picture (virilizing symptoms) leydigovyh determines the number of cells.
arrhenoblastoma intermediate type are a combination of the components of undifferentiated tumors, consisting of stromal sarcomatoid spindle-shaped cells, among which there are epithelioid cells, Leydig cells alone and in groups, or tube formation in the form of strands.
The disease often develops at a young age: from 20 to 35 years.The youngest patients are described as young as 4 years old, the oldest - at the age of 66 years.
The main symptoms of the disease are defiminizatsiya followed Virilization patient.The disease often begins with menstrual irregularities - delay menstruation, followed by persistent amenorrhea.
Much less observed monthly type metrorrhagia disorder, which subsequently replaced by amenorrhea.Disorders of the menstrual cycle may be preceded by the discovery of a tumor in a few years.At the same time, identify the symptoms of virilization: low gruff voice, hypertrichosis, acnae vulgaris, hypertrophy of the clitoris.
Sometimes, along with atrophy of the mammary glands, vanishes typical female fat padding on the hips and abdomen, and the patient becomes "masculine" appearance with a muscular body structure.
In more rare cases, there may be arrhenoblastoma feminizing effect in postmenopausal women is manifested in the form of uterine bleeding.
These hormonal studies indicate an increase in allocation of 17-keto steroids in the urine (up to the level of their allocation for men), but they never reach the values observed in tumors of the adrenal cortex.Maximal numbers isolation of 17-ketosteroids with arrhenoblastoma was 90 mg / 24 hours. After the operation, increased release of 17-keto steroids in urine is reduced to normal.However, it should be remembered that the definition of 17-keto steroids is only an indirect indicator of androgen production.Isolation of testosterone may increase significantly, while the excretion of 17-keto steroids is little impact.Pregnandiol often absent, but sometimes at the level of the average values of the normal luteal phase of the cycle.Held and Schreiner are not found in the urine of patients with no arrhenoblastoma pregnandiol nor pregnantriola.
Regarding the excretion of gonadotropins, the level of excretion is low, but they are not completely suppressed by the increased release of testosterone.
gynecological examination of patients arrhenoblastoma marked reduction in size of the uterus, vaginal mucosa smoothing.The tumor usually affects one ovary with the presence of ovarian atrophy another, but also found sided localization of the tumor.Tumor size do not exceed 10.7 cm in diameter, but in some cases, the tumor reached a value of child head.
- hormone producing tumors of the ovaries
- Ovarian tumors of the elements of the male gonads - arrhenoblastoma
- Theca cell tumor of ovary Tecom
- menstrual cycle Hormonal
- menstrual irregularities
- granulosa tumor.Follikuloma
- 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
disease develops slowly over several years, some clinical symptoms of disease, without a corresponding increase in the ovary, often do not give reason to think about the presence of ovarian cancer.
There is a significant percentage of malignant transformation (20%).Malignant arrhenoblastoma prone to recurrence and metastasis.Pregnancy if arrhenoblastoma occurs very rarely.If it has, then a female fetus can develop androgyny.
arrhenoblastoma treated operative by: the tumor is removed along with the affected ovary.If you suspect a malignant degeneration of the patient must be subjected to radiation therapy.After surgical treatment, along with the restoration of the menstrual cycle and conception processes are restored.