Steroid Cell Tumor NOS and Xanthogranulomatous Oophoritis: A Rare Association Mimicking Ovarian Malignancy
DOI:
https://doi.org/10.21276/apalm.3272Keywords:
ovary, tumor, inflammation, immunohistochemistry, oophoritisAbstract
Steroid cell tumor, NOS is an infrequently reported ovarian tumor, rarely presenting without endocrine symptoms. Xanthogranulomatous inflammation of ovaries is an extremely rare finding which often mimics malignancy on imaging. This case report presents a unique co-incidental finding of these two rare entities as incidental findings.
A 44 year old female with previous history of total abdominal hysterectomy for leiomyoma presented with abdominal discomfort. Clinical examination revealed bilateral adnexal mass. Imaging suggested a possibility of bilateral ovarian mucinous cystadenocarcinoma. CEA, CA19-9 and CA125 were within normal limit. No signs and symptoms of endocrine manifestation were seen. Bilateral salpingo-oophorectomy specimen was sent for histopathological examination. Grossly, Left ovary showed a single yellow nodule measuring 1cm in diameter. Right ovary showed a gray tan cut surface.
Microscopic examination revealed a left ovarian nodule composed of diffuse sheet of large tumor cell with abundant eosinophilic cytoplasm, round nucleus with a prominent nucleolus in a background of extensive vascular congestion. No reinke crystals, mitosis, necrosis, hemorrhage or nuclear atypia was seen. The tumor cells were immunopositive for Vimentin, Pan CK and Inhibin. Adjacent left ovarian stroma and right ovary showed features suggestive of XI. A diagnosis of Steroid cell tumor, NOS with xanthogranulomatous oophoritis was offered.
Steroid cell tumor and xanthogranulomatous oophoritis, both are rare entities which may mimic malignancy. Awareness of these entities alone or in combination allows a clinician to avoid radical surgeries in such cases.
References
Hayes MC, Scully RE. Ovarian steroid cell tumors (not otherwise specified): A clinicopathological analysis of 63 cases. Am J Surg Pathol. 1987(11);835-45.
Chun YJ, Choi HJ, Lee HN, Cho S, Choi JH. An asymptomatic ovarian steroid cell tumor with complete cystic morphology: A case report. Obstet Gynecol Sci. 2013;56(1):50-5.
T. Manandhar, Rajbhandari s, Thakur A,, et al. Xanthogranulomatous salpingo-oophoritis presenting as an ovarian malignancy Cureus. 2021;13(2):e13363.
WHO Classification of Tumours Editorial Board. Female Genital Tumours: WHO Classification of Tumours, 5th ed.; IARC: Lyon, France, 2020;Volume 4.
Taylor HB, Norris HJ. Lipid cell tumors of the ovary. Cancer. 1967;20(11):1953-62.
Baloglu A, Bezircioglu I, Cetinkaya B, Karci L, Bicer M. Development of secondary ovarian lesions after hysterectomy without oophorectomy versus unilateral oophorectomy for benign conditions: a retrospective analysis of patients during a nine-year period of observation. Clin Exp Obstet Gynecol. 2010;37(4):299-302.
Bernasconi D, Monte PD, Marinaro E, Marugo A, Marugo M. Severe postmenopausal hyperandrogenism due to an ovarian lipoid cell tumor: a case report. Minerva Endocrinol 2004;29(1):25-9.
Cserepes E, Szucs N, Patkos P, Csapo Z, Molnar F, Toth M, et al. Ovarian steroid cell tumor and a contralateral ovarian thecoma in a postmenopausal woman with severe hyperandrogenism. Gynecol Endocrinol. 2002;16(3):213-6.
Kim YT, Kim SW, Yoon BS, Kim SH, Kim JH, Kim JW, et al. An ovarian steroid cell tumor causing virilization and massive ascites. Yonsei Med J. 2007;48(1):142-6.
Vulink AJ, Vermes I, Kuijper P, ten Cate LN, Schutter EM. Steroid cell tumour not otherwise specified during pregnancy: a case report and diagnostic work-up for virilisation in a pregnant patient. Eur J Obstet Gynecol Reprod Biol. 2004;112(2):221-7.
Jones MW, Harri R, Dabbs DJ, Carter GJ. Immunohistochemical profile of steroid cell tumor of the ovary: a study of 14 cases and a review of the literature. Int J Gynecol Pathol. 2010;29(4):315-20.
Bindu SM, Mahajan MS. Xanthogranuloma-tous oophoritis: A case report with review of literature. Int J Health Allied Sci 2014;3:187-9.
George B, Clement C. G. Xanthogranulomatous salpingo-oophoritis associated with diverticular perforation. Human Pathology: Case Reprts. 2021;25:200539.
Kalloli M, Bafna UD, Mukherjee G, Devi UK, Gurubasavangouda, Rathod PS. A Rare Xantho- granulomatous oophoritis presenting as ovarian cancer. Online J Health Allied Sci. 2012;11:1–2.
Kim SH, Kim SH, Yang DM, Kim KA. Unusual causes of tubo-ovarian abscess: CT and MR imaging findings. Radiographics. 2004;24(6):1575–89.
Punia RS, Aggarwal R, Amanjit, Mohan H. Xanthogranulomatous oophoritis and salpingi-tis: late sequelae of inadequately treated staphy-lococcal PID. Indian J Pathol Microbiol 2003; 46:80.
Zhang XS, Dong HY, Zhang LL, Desouki MM, Zhao C. Xanthogranulomatous inflammation of the female genital tract:report of three cases. J Cancer. 2012;3:100-6.
Laishram S, Shimray R, Pukhrambam GD, Sarangthem B, Sharma AB. Xanthogranulomatous inflammatory lesions: a 10-year clinicopathological study in a teaching hospital. Bangladesh Journal of Medical Science. 2014;13:302–5.
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