A Rare Benign Tumor and an Associated Malignancy: Case Report of Ovarian Fibroma with Minor Sex Cord Elements and Uterine Endometrioid Adenocarcinoma

Excerpt

Ovarian stromal tumor with minor sex cord elements is a rare entity among the unclassified sex cord stromal tumor first described in 1983 by Young and Scully as a predominantly fibromatous or thecomatous tumor with minor sex cord elements comprising less than 10 % of the tumor area [1]. Typically, ovarian stromal tumors are hormonally inactive but sometimes secrete estrogen stimulating the endometrium to proliferate. The additional sources of estrogen from sex cord elements further predispose these patients to endometrial carcinoma. To the best of our knowledge, only three cases of ovarian stromal tumor with minor sex cord elements coexisting with endometrial carcinoma have been reported in the literature [1‐3]. However, none of these cases were of uniformly fibromatous type. We report a case of ovarian fibroma with minor sex cord elements in a 55-year-old postmenopausal female who presented with heaviness in the lower abdomen and bleeding per vagina. The patient also had focal well-differentiated endometrioid adenocarcinoma and complex atypical endometrial hyperplasia of the uterus indicating the hormone overproduction by the ovarian tumor. This is the first case report describing the ovarian fibroma with minor sex cord elements, showing evidence of estrogenic manifestation in the form of endometrioid adenocarcinoma. …