title: Recurrent endometrial hyperplasia as a presentation of estrogen-secreting thecoma - case report and minireview of the literature.
abstract: Thecoma is a rare ovarian tumor, presenting usually in postmenopausal women as unilateral, benign, solid lesion. About 15% of affected patients develop endometrial hyperplasia (EH) and 20% are diagnosed with endometrial cancer. In this case report, we present 60-year-old women admitted because of recurrent spotting of 5 years duration, which started 1 year after menopause. In history, the patient underwent three times curettage procedures and once (1 year before admission) had estradiol levels typical for reproductive-age women. At admission, we found elevated serum levels of estradiol (222.5 pg/ml) and a small mass in the right ovary. The markers of germ cell tumors were negative. After the initial diagnosis, the patient was qualified for total abdominal hysterectomy with bilateral salpingo-oophorectomy. The histopathological examination and immunohistochemical staining confirmed the thecoma diagnosis. In follow-up examination after 8 weeks, we found decreased serum estradiol levels and relief of the symptoms. In conclusion, we want to underline that in cases of EH, especially in patients with a history of recurrences, the special attention should be paid for differential diagnosis. In such cases, the estrogen-secreting tumors should be excluded.
authors.affiliation: a Department of Gynecological Endocrinology .
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Podfigurna-Stopa
authors.affiliation: a Department of Gynecological Endocrinology .
authors.forename: Adam
authors.initials: A
authors.lastname: Czyzyk
authors.affiliation: a Department of Gynecological Endocrinology .
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Katulski
authors.affiliation: b Division of Gynecological Surgery , Poznan University of Medical Sciences , Poznan , Poland , and.
authors.forename: Rafal
authors.initials: R
authors.lastname: Moszynski
authors.affiliation: b Division of Gynecological Surgery , Poznan University of Medical Sciences , Poznan , Poland , and.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sajdak
authors.affiliation: c Department of Obstetrics and Gynecology , University of Pisa , Pisa , Italy.
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Genazzani
authors.affiliation: a Department of Gynecological Endocrinology .
authors.forename: Blazej
authors.initials: B
authors.lastname: Meczekalski
mesh_terms: D004717:Endometrium / Q000473:pathology; D004967:Estrogens / Q000378:metabolism; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D010053:Ovary / Q000473:pathology; D013798:Thecoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology
chemical_list: D004967:Estrogens
keywords: Endometrial hyperplasia; hormone-secreting ovarian tumors; thecoma