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Publication
Post-menopausal metrorrhagia - an ovarian thecoma presentation
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Advisor(s)
Abstract(s)
Os tecomas são tumores raros do ovário, do
grupo dos tumores dos cordões sexuais, de
natureza sólida e frequentemente unilaterais.
Têm maior incidência no período pósmenopausa
e normalmente são silenciosos.
Quando sintomáticos traduzem-se por dor
pélvica e metrorragia (condicionada pela
habitual natureza produtora de estrogénios do
tumor). Podem ser concomitantes a síndrome
de Meigs e/ou de Golin-Goltz e associaremse
a transformação benigna ou maligna do
endométrio. Embora a ecografia possa ser
inespecífica neste contexto, uma avaliação
multiparamétrica abrangente em ressonância
magnética, incluindo por estudo dinâmico e
com ponderação em difusão, permite
frequentemente orientar de modo favorável a
marcha diagnóstica.
Apresentamos um caso raro de tecoma do
ovário, com espessamento associado do
endométrio, avaliado por ecografia
ginecológica por vias supra-púbica e
transvaginal bem como tomografia
computorizada e ressonância magnética,
confirmado cirurgicamente. Tratou-se de uma
examinada caucasiana de 61 anos de idade,
apresentando-se com metrorragia pósmenopáusica,
sem outros sintomas nem
contexto familiar relevante. Procedeu-se, a este
propósito, a uma revisão da literatura focada
no diagnóstico multimodal diferencial,
apresentação clínica, tratamento e prognóstico
destes tumores.
Thecomas represent rare, solid sex-cord stromal ovarian tumors, often unilateral, asymptomatic and occurring in postmenopausal patients. When symptomatic, they most commonly present with pelvic pain and metrorrhagia (due to their frequent estrogenic releasing nature). Thecomas can occur concomitantly with Meigs and/or Golin-Goltz syndrome and may also be associated with benign or malign endometrial transformation. Although gynecologic transabdominal and transvaginal ultrasound can be quite unspecific in this particular solid ovarian tumor presentation, magnetic resonance imaging including diffusion and dynamic data can frequently suggest the diagnosis and significantly facilitate the diagnostic work-up. We report a rare case of ovarian thecoma, with concomitant endometrial thickening, demonstrated by gynecologic transvaginal ultrasonography, computed tomography and magnetic resonance contrasted imaging, surgically confirmed. The patient was a 61 years old caucasian female presenting with postmenopausal metrorrhagia, without other associated symptoms nor family medical context. On this regard, we performed a review of the literature, focused on multimodal differential diagnosis imaging, clinical presentation, treatment and prognostic of this pathological finding.
Thecomas represent rare, solid sex-cord stromal ovarian tumors, often unilateral, asymptomatic and occurring in postmenopausal patients. When symptomatic, they most commonly present with pelvic pain and metrorrhagia (due to their frequent estrogenic releasing nature). Thecomas can occur concomitantly with Meigs and/or Golin-Goltz syndrome and may also be associated with benign or malign endometrial transformation. Although gynecologic transabdominal and transvaginal ultrasound can be quite unspecific in this particular solid ovarian tumor presentation, magnetic resonance imaging including diffusion and dynamic data can frequently suggest the diagnosis and significantly facilitate the diagnostic work-up. We report a rare case of ovarian thecoma, with concomitant endometrial thickening, demonstrated by gynecologic transvaginal ultrasonography, computed tomography and magnetic resonance contrasted imaging, surgically confirmed. The patient was a 61 years old caucasian female presenting with postmenopausal metrorrhagia, without other associated symptoms nor family medical context. On this regard, we performed a review of the literature, focused on multimodal differential diagnosis imaging, clinical presentation, treatment and prognostic of this pathological finding.
Description
Keywords
Tecoma Ovário Ecografia Tomografia computadorizada Ressonância magnética Thecoma Ovary Ultrasound Computed tomography Magnetic resonance
Pedagogical Context
Citation
Alexandre Batista; Teresa Margarida Cunha. Post-Menopausal Metrorrhagia – An Ovarian Thecoma Presentation, Acta Radiológica Portuguesa, XXVI, 103, 61-65, 2014.