Sex cord-gonadal stromal tumor
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Sex cord-gonadal stromal tumor
Reproductive system
Female reproductive system disorders
Amenorrhea
Breast cancer
Fibrocystic breast changes
Intraductal papilloma
Mastitis
Paget disease of the breast
Phyllodes tumor
Intrauterine growth restriction
Oligohydramnios
Polyhydramnios
Potter sequence
Postpartum hemorrhage
Preterm labor
Pelvic inflammatory disease
Urethritis
Ectopic pregnancy
Gestational trophoblastic disease
Miscarriage
Germ cell ovarian tumor
Krukenberg tumor
Ovarian cyst
Ovarian torsion
Polycystic ovary syndrome
Premature ovarian failure
Sex cord-gonadal stromal tumor
Surface epithelial-stromal tumor
Chorioamnionitis
Congenital cytomegalovirus (NORD)
Congenital rubella syndrome
Congenital syphilis
Congenital toxoplasmosis
Neonatal conjunctivitis
Neonatal herpes simplex
Neonatal meningitis
Neonatal sepsis
Cervical incompetence
Gestational diabetes
Gestational hypertension
Hyperemesis gravidarum
Placenta accreta
Placenta previa
Placental abruption
Preeclampsia & eclampsia
Female sexual interest and arousal disorder
Genito-pelvic pain and penetration disorder
Orgasmic dysfunction
Fetal alcohol syndrome
Fetal hydantoin syndrome
Cervical cancer
Choriocarcinoma
Endometrial cancer
Endometrial hyperplasia
Endometriosis
Endometritis
Uterine fibroid
Male and female reproductive system disorders
Delayed puberty
Precocious puberty
5-alpha-reductase deficiency
Androgen insensitivity syndrome
Kallmann syndrome
Klinefelter syndrome
Turner syndrome
Male reproductive system disorders
Bladder exstrophy
Hypospadias and epispadias
Penile cancer
Priapism
Benign prostatic hyperplasia
Prostate cancer
Prostatitis
Erectile dysfunction
Male hypoactive sexual desire disorder
Cryptorchidism
Epididymitis
Inguinal hernia
Orchitis
Testicular cancer
Testicular torsion
Varicocele
Reproductive system pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Cervical cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sex chromosomes: Pathology review
Disorders of sexual development and sex hormones: Pathology review
HIV and AIDS: Pathology review
Ovarian cysts and tumors: Pathology review
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Testicular and scrotal conditions: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Vaginal and vulvar disorders: Pathology review
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Sex cord-gonadal stromal tumor
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Which of the following is most likely to be elevated in this patient?
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With sex cord-stromal ovarian cancer, Ovarian refers to “ovary”, of which women have two that sit along either side of the uterus. The term sex cord refers to an embryonic structures that develop into ovarian follicles and stromal cells are the connective tissue of any organ. So a sex cord-stromal ovarian cancer is a type of tumor that develops from either ovarian follicle cells or connective tissue cells.
Each ovary has multiple follicles. Each follicle is made up of an oocyte, which is an immature egg, surrounded by two types of cells - theca cells and granulosa cells. Granulosa and theca cells work together to support follicle development. Luteinizing hormone stimulates theca cells to generate androgens and follicle stimulating hormone stimulates granulosa cells to convert those androgens to estradiol using the enzyme aromatase. A large increase in estradiol triggers ovulation.
During ovulation, the oocyte pops out of the ovary, causing a bit of damage to the surface. Fibrocytes detect that damage and differentiate into fibroblasts and lay down collagen to help repair the damage.
If any of those cells starts to divide uncontrollably, it can either form a benign tumor which means that it doesn’t invade nearby tissue or spread to other parts of the body, or it can be a malignant tumor which means that it can invade nearby tissue and spread to other parts of the body. Compared with benign tumor cells, malignant tumor cells have key features like not having a clearly defined border or like having slightly less organized nuclei.
The first main type of sex-cord stromal tumor is a granulosa-theca cell tumor. And these are the most common malignant stromal tumors and they’re associated with middle-aged women. These tumors often end up producing way too much estradiol, and this can cause very specific hormone associated symptoms like uterine bleeding, breast tenderness, and early puberty in young girls. Under the microscope, these tumors classically develop little fluid pockets scattered throughout the tissue that are called Call-Exner bodies.
Summary
Sex cord-stromal ovarian cancer is a type of tumor that develops from either ovarian follicle cells, or connective tissue cells. Some of these tumors are granulosa-theca cell tumors and Sertoli-Leydig cell tumors. Granulosa-theca cell tumors produce excess estradiol, which can cause very specific hormone-associated symptoms like uterine bleeding, breast tenderness, and early puberty in young girls. Sertoli-Leydig cell tumors can secrete excess testosterone, which can cause women to have more masculine features like hirsutism, which is increased hair growth.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Mucinous Tumors of the Ovary: Current Thoughts on Diagnosis and Management" Current Oncology Reports (2014)
- "Sex Cord-Gonadal Stromal Tumor of the Rete Testis" Advances in Urology (2009)
- "Ovarian sex cord?stromal tumors?a clinicopathological study of 72 cases from the Kiel Pediatric Tumor Registry" Virchows Archiv (2003)
- "CD56 Is a Sensitive and Diagnostically Useful Immunohistochemical Marker of Ovarian Sex Cord-Stromal Tumors" International Journal of Gynecological Pathology (2007)
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