Luteinized thecoma associated with sclerosing peritonitis--conservative surgical approach followed by corticosteroid and GnRH agonist treatment--a case report.
BACKGROUND
Luteinized thecoma of the ovary associated with sclerosing peritonitis is a rare tumor that has no standard definitive treatment regimen.


METHODS
A 25 year-old patient diagnosed with luteinized thecoma and sclerosing peritonitis in the omentum. The patient received high dose corticosteroids (IV Hydrocortisone 500 mg/d) and GnRH agonist (IM Leuprolide 3.75 mg) in order to achieve ovarian suppression and relief of the clinical peritonitis. She was re-admitted two weeks later due to bowel obstruction which was treated conservatively. The steroid regimen was continued by oral intake for 5 weeks with complete remission of the peritonitis related symptoms. The bilateral enlarged ovarian tumor-like solid was the prominent finding in consecutive ultrasound exams with no decrease in size despite of the above mentioned protocol. Thus, the patient was re-operated for exploration and biopsies of the ovary and the pathology report showed no evidence of remnant disease in the ovary, or in the peritoneum. Completing follow-up of 15 months since the last operation, the patient is asymptomatic. She conceived spontaneously and currently is in her 24th week of a normal pregnancy.


CONCLUSIONS
This is the first case report in the English literature of a successful medical conservative treatment of a young patient with luteinized thecoma associated with sclerosing peritonitis that led to complete relief of the symptoms and allowed fertility preservation.
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel.
R
R
Schonman
Z
Z
Klein
E
E
Edelstein
B
B
Czernobilsky
A
A
Fishman
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D016729:Leuprolide / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D010538:Peritonitis / Q000150:complications / Q000473:pathology / Q000628:therapy*; D012598:Sclerosis; D013798:Thecoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
D016729:Leuprolide; D006854:Hydrocortisone