RESUMO
Two cases of ovarian leiomyoma as casual findings in oophorectomy specimens are reported. Both were small (1.5 and 1.0 cm), one had leiomyoblastomatous and symplastic features, and the other was associated with an adjoining multilocular mucinous cystadenoma and atypical hyperplasia in the endometrium. Both coexisted with uterine leiomyomas, which they resemble morphologically. Distinction from thecoma-fibroma was made by the immunohistochemical demonstration of desmin and characteristic electronmicroscopic features of smooth muscle.
Assuntos
Leiomioma/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Ovarianas/patologia , Neoplasias Uterinas/patologia , Adulto , Desmina/análise , Diagnóstico Diferencial , Feminino , Humanos , Leiomioma/ultraestrutura , Microscopia Eletrônica , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/ultraestrutura , Neoplasias Ovarianas/ultraestrutura , Neoplasias Uterinas/ultraestruturaRESUMO
A case of malignant, complex sex cord tumor with multiple differentiations in a 38-year-old woman is presented. The neoplasm presented originally as a pure granulosa cell tumor, and in the second look operation as a sex cord tumor with annular tubules (SCTAT). Six years later abdominal metastases revealed a mixed pattern of granulosa and Sertoli cell tumor admixed with SCTAT. The patient died despite chemotherapy. Analysis of the 10 previously reported cases of malignant SCTAT shows that tumor size is the main prognostic indicator. Mitoses, atypia, and stromal invasion seem also to bear prognostic implications when present. The association of both granulosa and Sertoli cells with SCTAT seems to provide a clue for SCTAT being a peculiar intermediate phenotypical expression of pluripotential stem sex cord cells of the gonads.
