Sclerosing peritonitis associated with a luteinized adult granulosa cell tumor.
ABSTRACT Sclerosing peritonitis is an uncommon condition that has been reported in patients with luteinized ovarian thecomas, although some pathologists have suggested that the underlying ovarian pathology is not always neoplastic. We now report sclerosing peritonitis in a patient with an uncommon, luteinized variant of an adult granulosa cell tumor. To the best of our knowledge, this association has not been described previously. We suggest that sclerosing peritonitis may result from the release of substances by luteinized ovarian stromal cells, in the context of hyperplasia or neoplasia, which stimulate the proliferation of submesothelial fibroblasts.
- SourceAvailable from: ncbi.nlm.nih.gov[Show abstract] [Hide abstract]
ABSTRACT: Background. Granulosa cell tumors (GCTs), representing ~2% of ovarian tumours, are poorly understood neoplasms with unpredictable and undetermined biological behaviour. Design. 5 unusual presentations of GCT and a retrospective 14-year (1997-2011) surgical pathology review based on patient sex, age, tumour type and concurrent pathology findings are presented to discuss the "myths and realities" of GCTs in the context of relevant evidence-based literature. Results. The 5 index cases included (1) a 5 month-old boy with a left testicular mass, (2) a 7-day-old neonate with a large complex cystic mass in the abdomen, (3) a 76-year-old woman with an umbilical mass, (4) a 64-year-old woman with a complex solid-cystic pelvic mass, and (5) a 45 year-old woman with an acute abdomen. Pathological analysis confirmed the final diagnosis as (1) juvenile GCT, (2) macrofollicular GCT, (3) recurrent GCT 32 years later, (4) collision tumour: colonic adenocarcinoma and GCT, and (5) ruptured GCT. Conclusion. GCT is best considered as an unusual indolent neoplasm of low malignant potential with late recurrences that can arise in the ovaries and testicles in both the young and the old. Multifaceted clinical presentations coupled with the unpredictable biological behaviour with late relapses are diagnostic pitfalls necessitating a high degree of suspicion for accurate clinical and pathological diagnosis.ISRN obstetrics and gynecology 09/2012; 2012:878635. DOI:10.5402/2012/878635
- [Show abstract] [Hide abstract]
ABSTRACT: Case RepoRt An 18-year-old female presented with lower abdominal pain of one month's duration. She had fever, two days prior to her admission. There was no history of weight loss, loss of appetite or bleeding per vagina. Age of menarche was 14 years. Menstrual cycles were normal. General examination was normal. Per-abdomen examination revealed diffuse distension, guarding and rigidity. Per-rectum showed fullness in the right fornix caused by a mass of size, 5 x 5 cm, which was felt in the right adnexae, which was hard and fixed. Uterus could not be felt separately. Clinically, a diagnosis of a right tuboovarian mass with ascitis was made. Ultrasound and computed tomography suggested presence of a solid cystic mass in the right ovary. Exploratory laparotomy was performed. Per-operative findings: Ascitis was noted along with a right ovarian tumour, the posterior wall of which was ruptured. Also seen were multiple grey white indurated nodules which were approximately one cm in diameter, over the peritoneal surface. Marked adhesions were seen in the bilateral paracolic gutter, pouch of Douglas, posterior wall of the uterus and the adjacent rectum. Hysterectomy with unilateral salpingooophorectomy, with sampling from the bilateral paracolic gutter, pouch of Douglas and peritoneal nodules was done. Gross: Right ovary was replaced by a tumour which measured 12 x 9 x 7 cm. External surface was bosselated. Cut surface was solid grey, white to grey yellow, with areas of myxoid changes, fine cystic changes and haemorrhage. Tissue which was sampled from bilateral paracolic gutter and pouch of Douglas consisted of grey white to grey brown flap like tissue which measured 4.5 x 2.5 x 1.3 cm. Omentum consisted of fibro fatty tissue with tiny nodules, which were 0.5 cm across.Journal of Clinical and Diagnostic Research 03/2014; 8(3):123-124. · 0.13 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Sclerosing Peritonitis (SP) is characterized by fibrous thickening and adhesions of the peritoneum and it is encountered frequently in association with peritoneal dialysis, practolol and anticonvulsant therapy. Rarely does it present as a gynaecological complication, most commonly in conjunction with luteinized thecoma of ovary. Very rarely has sclerosing peritonitis been reported to occur with ovarian cystic teratoma and a luteinized variant of adult granulosa cell tumour, among which only one case has been reported in the English literature. An 18-year-female presented with a history of lower abdominal pain, of one month's duration. At surgery, an ovarian mass was noted, along with adhesion of bowel loops which were enclosed within a diffusely thickened peritoneal membrane, forming a cocoon. Adhesions were seen in bilateral paracolic gutter and infracolic omentum, which were suggestive of metastatic deposits. Histopathology of ovarian lesion was interpreted as a juvenile granulosa cell tumour. The peritoneal process revealed sclerosing peritonitis. We emphasize this rare association of sclerosing peritonitis with juvenile granulosa cell tumour and that the peritoneal process of sclerosing peritonitis in a juvenile granulosa cell tumour should not lead to over staging of an ovarian tumour.03/2014; 8(3):123-124. DOI:10.7860/JCDR/2014/6825.4131