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Thecoma

MedGen UID:
21505
•Concept ID:
C0039747
•
Neoplastic Process
Synonyms: Theca Cell Tumor; Theca Cell Tumors; Thecomas; Tumor, Theca Cell; Tumors, Theca Cell
 
Monarch Initiative: MONDO:0037252

Definition

An ovarian or testicular stromal tumor characterized by the presence of lipid-rich neoplastic spindle cells. In females, uterine bleeding is the most common symptom. A minority of post-menopausal women with thecoma have an associated endometrial adenocarcinoma or rarely a malignant mixed mullerian tumor or endometrial stromal sarcoma. Rare cases with nuclear atypia and mitotic activity may metastasize. In males, thecomas are rare and they usually present as slow growing, sometimes painful masses. Metastases have not been reported. [from NCI]

Professional guidelines

PubMed

Value of diffusion-weighted imaging combined with conventional magnetic resonance imaging in the diagnosis of thecomas and their differential diagnosis with adult granulosa cell tumors.
Fang M, Dong J, Zhong Q, Fang X, Chen Y, Wang C, Yan H
Acta Radiol 2019 Nov;60(11):1532-1542. Epub 2019 Feb 18 doi: 10.1177/0284185119830280. PMID: 30776906
Thecoma of the ovary: a report of 70 cases emphasizing aspects of its histopathology different from those often portrayed and its differential diagnosis.
Burandt E, Young RH
Am J Surg Pathol 2014 Aug;38(8):1023-32. doi: 10.1097/PAS.0000000000000252. PMID: 25025365
Smooth muscle tumors of the ovary: a clinicopathologic study of 54 cases emphasizing prognostic criteria, histologic variants, and differential diagnosis.
Lerwill MF, Sung R, Oliva E, Prat J, Young RH
Am J Surg Pathol 2004 Nov;28(11):1436-51. doi: 10.1097/01.pas.0000141393.99300.d0. PMID: 15489647

Recent clinical studies

Etiology

Coexisting ovarian serous cystadenoma with fibroma: A very unusual combination.
Balhara K, Mallya V, Khurana N, Tempe A
J Cancer Res Ther 2023 Jul-Sep;19(5):1474-1476. doi: 10.4103/jcrt.jcrt_2319_21. PMID: 37787335
Comprehensive review of imaging features of sex cord-stromal tumors of the ovary.
Javadi S, Ganeshan DM, Jensen CT, Iyer RB, Bhosale PR
Abdom Radiol (NY) 2021 Apr;46(4):1519-1529. Epub 2021 Mar 16 doi: 10.1007/s00261-021-02998-w. PMID: 33725145
Ovarian sex cord-stromal tumours and their mimics.
Young RH
Pathology 2018 Jan;50(1):5-15. Epub 2017 Nov 11 doi: 10.1016/j.pathol.2017.09.007. PMID: 29132723
Recent advances in the pathology and classification of ovarian sex cord-stromal tumors.
Roth LM
Int J Gynecol Pathol 2006 Jul;25(3):199-215. doi: 10.1097/01.pgp.0000192271.22289.e6. PMID: 16810055
Sex cord-stromal tumours of the ovary.
Fox H
J Pathol 1985 Feb;145(2):127-48. doi: 10.1002/path.1711450202. PMID: 2983057

Diagnosis

Brenner tumors.
Costeira FS, Félix A, Cunha TM
Br J Radiol 2022 Feb 1;95(1130):20210687. Epub 2021 Dec 20 doi: 10.1259/bjr.20210687. PMID: 34928171Free PMC Article
Ovarian Fibrothecoma.
Schoolmeester JK, Erickson LA
Mayo Clin Proc 2019 Aug;94(8):1652-1653. doi: 10.1016/j.mayocp.2019.04.019. PMID: 31378246
Practical Review of Ovarian Sex Cord-Stromal Tumors.
Hanley KZ, Mosunjac MB
Surg Pathol Clin 2019 Jun;12(2):587-620. doi: 10.1016/j.path.2019.02.005. PMID: 31097116
Luteinized Fibrothecoma.
Haghayeghi K, Hansen K, Quddus MR
Int J Surg Pathol 2019 Sep;27(6):654-655. Epub 2018 Dec 6 doi: 10.1177/1066896918817372. PMID: 30520326
Ovarian sex cord-stromal tumours and their mimics.
Young RH
Pathology 2018 Jan;50(1):5-15. Epub 2017 Nov 11 doi: 10.1016/j.pathol.2017.09.007. PMID: 29132723

Therapy

COMPLETE REMISSION OF MEDICALLY TREATED LUTEINIZED THECOMAS WITH SCLEROSING PERITONITIS.
Wehbe K, Duminil L, Bertrand A, Kianmanesh R, Graesslin O, Raimond E
J Gynecol Obstet Hum Reprod 2021 Jun;50(6):101734. Epub 2020 Apr 10 doi: 10.1016/j.jogoh.2020.101734. PMID: 32283225
Granulosa and theca cell tumor in rat's ovary after modified Biskind operation.
Shamrai D, Koshik E, Melnyk N
Exp Oncol 2020 Dec;42(4):306-309. doi: 10.32471/exp-oncology.2312-8852.vol-42-no-4.15424. PMID: 33355865
Management of non-epithelial ovarian tumours.
Bridgewater JA, Rustin GJ
Oncology 1999;57(2):89-98. doi: 10.1159/000012014. PMID: 10461054
Steroid hormone-producing tumors in man.
Freeman DA
Endocr Rev 1986 May;7(2):204-20. doi: 10.1210/edrv-7-2-204. PMID: 3013606
The epidemiology of endometrial cancer.
Klopper A, Farr V
Front Horm Res 1977;5:89-100. doi: 10.1159/000401987. PMID: 208882

Prognosis

Incidental FOXL2 mutated adult granulosa cell tumour of the ovary with thecoma-like foci.
Fischer AK, Schömig-Markiefka B, Heydt C, Ratiu D, Mallmann P, Meinel J, Büttner R, Schmidt D, Quaas A
Virchows Arch 2023 Jul;483(1):117-124. Epub 2022 Nov 18 doi: 10.1007/s00428-022-03452-y. PMID: 36399188Free PMC Article
Comprehensive review of imaging features of sex cord-stromal tumors of the ovary.
Javadi S, Ganeshan DM, Jensen CT, Iyer RB, Bhosale PR
Abdom Radiol (NY) 2021 Apr;46(4):1519-1529. Epub 2021 Mar 16 doi: 10.1007/s00261-021-02998-w. PMID: 33725145
Ovarian Fibrothecoma.
Schoolmeester JK, Erickson LA
Mayo Clin Proc 2019 Aug;94(8):1652-1653. doi: 10.1016/j.mayocp.2019.04.019. PMID: 31378246
Practical Review of Ovarian Sex Cord-Stromal Tumors.
Hanley KZ, Mosunjac MB
Surg Pathol Clin 2019 Jun;12(2):587-620. doi: 10.1016/j.path.2019.02.005. PMID: 31097116
Steroid hormone-producing tumors in man.
Freeman DA
Endocr Rev 1986 May;7(2):204-20. doi: 10.1210/edrv-7-2-204. PMID: 3013606

Clinical prediction guides

FOXL2 Mutation Analysis of Ovarian Sex Cord-Stromal Tumors: Genotype-Phenotype Correlation With Diagnostic Considerations.
Buza N, Wong S, Hui P
Int J Gynecol Pathol 2018 Jul;37(4):305-315. doi: 10.1097/PGP.0000000000000426. PMID: 28700438
On the pathogenesis of sclerosing stromal tumor of the ovary: a neoplasm in transition.
Roth LM, Gaba AR, Cheng L
Int J Gynecol Pathol 2014 Sep;33(5):449-62. doi: 10.1097/PGP.0000000000000084. PMID: 25083960
Aspiration cytology of 147 adnexal cysts with histologic correlation.
Martínez-Onsurbe P, Ruiz Villaespesa A, Sanz Anquela JM, Valenzuela Ruiz PL
Acta Cytol 2001 Nov-Dec;45(6):941-7. doi: 10.1159/000328368. PMID: 11726122
Transplantation of reproductive organs.
Lee S, Mao L, Wang Y, D'Silva M, Yoo CH, Wolf P, Chung WS, Takahashi E, Chung DY, Gittes RF
Microsurgery 1995;16(4):191-8. doi: 10.1002/micr.1920160406. PMID: 7674907
Trisomy 12 and 4 in a thecoma of the ovary.
Mrózek K, Limon J, Debniak J, Emerich J
Gynecol Oncol 1992 Apr;45(1):66-8. doi: 10.1016/0090-8258(92)90493-3. PMID: 1318257

Recent systematic reviews

Luteinized thecoma (thecomatosis) with sclerosing peritonitis: a systematic review of the literature of the last 25 years.
Muratori L, Trevisi E, Delcuratolo MD, Sperone P, Di Maio M
Expert Rev Anticancer Ther 2021 Jan;21(1):23-32. Epub 2020 Oct 22 doi: 10.1080/14737140.2021.1837629. PMID: 33053314
Feto-maternal outcomes of pregnancy complicated by ovarian sex-cord stromal tumor: a systematic review of literature.
Blake EA, Carter CM, Kashani BN, Kodama M, Mabuchi S, Yoshino K, Matsuo K
Eur J Obstet Gynecol Reprod Biol 2014 Apr;175:1-7. Epub 2013 Dec 25 doi: 10.1016/j.ejogrb.2013.12.025. PMID: 24439718

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