obsolete tumor of the thecoma fibroma group

Thecoma: An Obsolete Tumor Type

The thecoma is an uncommon and noncancerous type of ovarian tumor that was once considered a distinct entity within the sex cord-stromal tumor group. However, with advancements in pathology and classification systems, it has largely been reclassified as a subtype of fibroma or other sex cord-stromal tumors.

Characteristics

Thecoma tumors are typically composed of cells resembling theca interna cells, which are found in the ovarian stroma. They can produce estrogen, leading to hormonal imbalances and various symptoms such as abnormal uterine bleeding [10][12].

Clinical Features

Thecoma tumors were often discovered incidentally or presented with postmenopausal bleeding as the most common symptom [10]. In some cases, they could also be associated with endometrial carcinoma [12].

Treatment and Prognosis

Surgical removal was the primary treatment approach for thecoma tumors. Since these tumors are benign, once removed, symptoms typically resolve, and estrogen production stops [11].

Reclassification

With the evolution of pathology and classification systems, thecoma has been largely reclassified as a subtype of fibroma or other sex cord-stromal tumors. This reclassification reflects our improved understanding of ovarian tumor biology and nomenclature.

References:

[10] Ovary tumor - Thecoma is an ovarian stromal neoplasm, almost always benign, composed of cells resembling theca cells. [11] Thecomas or theca cell tumors are benign ovarian neoplasms composed only of theca cells. [12] 60% of patients present with abnormal uterine bleeding, and 20% have endometrial carcinoma.

Common Signs and Symptoms of Ovarian Thecoma-Fibroma Group

The ovarian thecoma-fibroma group, a rare type of sex cord-stromal neoplasm, can present with various symptoms. While these tumors are often benign, they can cause significant discomfort for patients.

• Abdominal pain: A common symptom, abdominal pain can range from mild to severe and may be accompanied by other symptoms such as bloating or constipation [12].
• Ascites: Fluid accumulation in the abdomen (ascites) is a frequent clinical feature, reported in 74% of cases [13].
• Bowel obstruction: Intestinal blockage due to tumor growth can cause symptoms like abdominal pain, nausea, and vomiting [13].
• Pelvic pain: Pain in the lower abdomen or pelvis is another common symptom, often accompanied by other signs such as vaginal bleeding or menstrual irregularity [14].

Less Common Symptoms

While not as frequent, some patients may experience:

• Vaginal bleeding: Unusual vaginal bleeding or spotting can occur due to hormonal imbalances caused by the tumor [7].
• Menstrual irregularities: Changes in menstrual cycle patterns, such as heavier or lighter periods, can be a symptom of ovarian thecoma-fibroma group tumors [14].

Important Note

It's essential to note that these symptoms can also be associated with other conditions. A definitive diagnosis can only be made through histopathological examination and surgical removal of the tumor.

References:

[12] Symptoms may include bloating, vaginal bleeding, pelvic pain, abdominal swelling, constipation, and loss of appetite, among others. Common areas to which ... (Search Result 11) [13] by R Schonman · 2008 · Cited by 16 — These tumors can be divided into typical, luteinized, and calcified forms. They are essentially benign with the exception of rare mitotically active atypical ... (Search Result 13) [14] by E Kuscu · Cited by 22 — The most common signs and symptoms are menstrual irregularity and pelvic pain. The majority of diagnosed SSTs have been non-functional, but some have produced ... (Search Result 14)

Based on the provided context, it appears that thecomas and fibromas are types of ovarian tumors that were once considered to be part of the same group, known as thecomas-fibroma group (OTFGs). However, they have since been reclassified into separate entities.

Diagnostic tests for these tumors typically involve a combination of imaging studies and laboratory tests. Here are some diagnostic methods mentioned in the context:

• Imaging studies: Magnetic Resonance Imaging (MRI) can be used to evaluate the characteristics of ovarian tumors, including their size, location, and texture [14]. However, it's worth noting that MRI-based characteristics alone may not be sufficient to distinguish between OTFGs and other types of ovarian tumors.
• Laboratory tests: Tumor markers such as CA-125, AFP, b-hCG, and LDH can be used to help diagnose ovarian cancer, including thecomas and fibromas [3]. However, these markers are not specific to these tumor types and may also be elevated in other conditions.
• Fine Needle Aspiration Cytology (FNAC): This is a minimally invasive procedure that involves inserting a thin needle into the tumor to collect cells for examination. FNAC can help exclude malignancy, but its results may vary depending on the type of tumor [5].
• Biopsy: A biopsy of tissue removed during surgery can confirm a diagnosis of ovarian cancer, including thecomas and fibromas [6].

It's also worth noting that the differential diagnosis for these tumors includes other types of ovarian neoplasms, such as granulosa cell tumors. The most common reason to perform FNAC is to exclude malignancy, but its results may vary depending on the type of tumor.

References:

[3] - Diagnostic test in ovarian cancer: prospective validation of the Risk of Ovarian Malignancy Algorithm. [5] - Fine needle aspiration cytology (FNAC) for diagnosing ovarian tumors. [6] - A diagnosis of ovarian cancer is confirmed through a biopsy of tissue, usually removed during surgery.

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