A rare occurrence of a malignant ovarian steroid cell tumor not otherwise specified: A case report and literature review

Li,Kai; Zhu,Fufan; Xiong,Jing; Liu,Fengying

doi:10.3892/ol.2014.2233

A rare occurrence of a malignant ovarian steroid cell tumor not otherwise specified: A case report and literature review

Authors:
- Kai Li
- Fufan Zhu
- Jing Xiong
- Fengying Liu
View Affiliations

Affiliations: Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
Published online on: June 6, 2014 https://doi.org/10.3892/ol.2014.2233
Pages: 770-774

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Steroid cell tumors not otherwise specified (NOS) are a rare subgroup of sex cord‑stromal tumors. The tumors can occur at any age, although the mean age of occurrence is 43 years old. The majority are benign, but have the capability of producing one or more steroids associated with virilization. The present study reports the case of a 29‑year‑old female who presented to the Second Xiangya Hospital suffering from lower back and leg pain that had persisted for five months. The patient had regular menstrual cycles and no virilization symptoms were present. Laboratory investigations revealed normal hormone levels. Multiple areas of bone destruction and a right ovarian mass were confirmed via positron emission tomography/computed tomography. The patient underwent an exploratory laparotomy, and a mass measuring ~6 cm in diameter was subsequently identified in the right ovary. A right salpingo‑oophorectomy and pelvic washings for cytology were performed. Histopathological studies confirmed the diagnosis of a malignant steroid cell tumor NOS of the right ovary. The patient underwent eight cycles of chemotherapy (docetaxel, 120 mg and nedaplatin, 80 mg). The patient continued to have relatively good health, with no deterioration of the condition for one year and a half, however, the disease progressed and the patient succumbed to brain metastases six months later.

View Figures

View References

1	Scully RE: Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. (Second Series Fascicle 16). Armed Forces Institute of Pathology; Washington, DC, USA: pp. 215–220. 1979
2	Hayes MC and Scully RE: Ovarian steroid cell tumors (not otherwise specified). A clinicopathological analysis of 63 cases. Am J Surg Pathol. 11:835–845. 1987.
3	Kim YT, Kim SW, Yoon BS, et al: An ovarian steroid cell tumor causing virilization and massive ascites. Yonsei Med J. 48:142–146. 2007.
4	Amneus MW and Natarajan S: Pathologic quiz case: a rare tumor of the ovary. Arch Pathol Lab Med. 127:890–892. 2003.
5	Novoa-Vargas A, Sánchez-Bautista K and Coudillo-Luna I: Malignant arrhenoblastoma. Case report and literature review. Ginecol Obstet Mex. 79:45–51. 2011.(In Spanish).
6	Galinier P, Carfagna L, Delsol M, et al: Ovarian torsion. Management and ovarian prognosis: a report of 45 cases. J Pediatr Surg. 44:1759–1765. 2009.
7	Sawathiparnich P, Sitthinamsuwan P, Sanpakit K, et al: Cushing’s syndrome caused by an ACTH-producing ovarian steroid cell tumor, NOS, in a prepubertal girl. Endocrine. 35:132–135. 2009.
8	Saida T, Tanaka YO and Minami M: Steroid cell tumor of the ovary, not otherwise specified: CT and MR findings. AJR Am J Roentqenol. 188:W393–W394. 2007.
9	Powell JL, Dulaney DP and Shiro BC: Androgen-secreting steroid cell tumor of the ovary. South Med J. 93:1201–1204. 2000.
10	Brewer CA and Shevlin D: Encouraging response of an advanced steroid-cell tumor to GnRH agonist therapy. Obstet Gynecol. 92:661–663. 1998.
11	Wang PH, Chao HT, Lee RC, et al: Steroid cell tumors of the ovary: clinical, ultrasonic, and MRI diagnosis - a case report. Eur J Radiol. 26:269–273. 1998.
12	Wang PH, Chao HT and Lee WL: Use of a long-acting gonadotropin-releasing hormone agonist for treatment of steroid cell tumors of the ovary. Fertil Steril. 69:353–355. 1998.
13	Wang PH, Chao HT, Liu RS, Cho YH, Ng HT and Yuan CC: Diagnosis and localization of testosterone-producing ovarian tumors: imaging or biochemical evaluation. Gynecol Oncol. 83:596–598. 2001.
14	Dowdy SC, O’Kane DJ, Keeney GL, Boyd J and Podratz KC: Telomerase activity in sex cord-stromal tumors of the ovary. Gynecol Oncol. 82:257–260. 2001.
15	Jiang W, Tao X, Fang F, Zhang S and Xu C: Benign and malignant ovarian steroid cell tumors, not otherwise specified: case studies, comparison, and review of the literature. J Ovarian Res. 6:532013.
16	Murhekar K, Louis R and Majhi U: A rare occurrence of a steroid cell tumor of the pelvic mesentery: a case report. J Med Case Rep. 5:5172011.
17	Mehdi G, Ansari HA, Sherwani RK, Rahman K and Akhtar N: Ovarian steroid cell tumor: correlation of histopathology with clinicopathologic features. Patholog Res Int. 2011:9878952011.
18	Glaspy JA, Hawkins RA, Hoh CK and Phelps ME: Use of positron emission tomography in oncology. Oncology (Williston Park. 7:41–46. 1993.
19	Taylor HB and Norris HJ: Lipoid cell tumors of the ovary. Cancer. 20:1953–1962. 1967.
20	Donovan JT, Otis CN, Powell JL and Cathcart HK: Cushing’s syndrome secondary to malignant lipoid cell tumor of the ovary. Gynecol Oncol. 50:249–253. 1993.
21	Anderson PW, D’Abling G III, Penny R, Sherrod A and Do YS: Secretion of prorenin by virilizing ovarian tumor. Gynecol Oncol. 45:58–61. 1992.
22	Reedy MB, Richards WE, Ueland F, et al: Ovarian steroid cell tumors, not otherwise specified: a case report and literature review. Gynecol Oncol. 75:293–297. 1999.
23	Lee SH, Kang MS, Lee GS and Chung WY: Refractory hypertension and isosexual pseudoprecocious puberty associated with rennin-secreting ovarian steroid cell tumor in a girl. J Korean Med Sci. 26:836–838. 2011.
24	Boyraz G, Selcuk I, Yusifli Z, et al: Steroid cell tumor of the ovary in an adolescent: a rare case report. Case Rep Med. 2013:5276982013.
25	Tsai HJ, Chen SC, Wei HY and Chen GD: Hypothyroidism and hyperlipidemia with a virilizing ovarian steroid cell tumor, not otherwise specified. Gynecol Endocrinol. 23:69–71. 2007.
26	Zhang X and Lü B: Ovarian steroid cell tumor, not otherwise specified (NOS): an unusual case with myelolipoma. Int J Gynecol Pathol. 30:460–465. 2011.
27	Kim YT, Kim SW, Yoon BS, et al: An ovarian steroid cell tumor causing virilization and massive ascites. Yonsei Med J. 48:142–146. 2007.
28	Sielert L, Liu C, Nagarathinam R and Craig LB: Androgen-producing steroid cell ovarian tumor in a young woman and subsequent spontaneous pregnancy. J Assist Reprod Genet. 30:1157–1160. 2013.
29	Jones MW, Harri R, Dabbs DJ and Carter GJ: Immunohistochemical profile of steroid cell tumor of the ovary: a study of 14 cases and a review of the literature. Int J Gynecol Pathol. 29:315–320. 2010.
30	Ye L, Wu XL, Xu L, Huang Q, et al: Ovarian steroid cell tumor, not otherwise specified: a clinicopathologic study. Zhonghua Bing Li Xue Za Zhi. 36:516–520. 2007.(In Chinese).
31	Gershenson DM, Copeland LJ, Kavanagh JJ, et al: Treatment of metastatic stromal tumors of the ovary with cisplatin, doxorubicin, and cyclophosphamide. Obstet Gynecol. 70:765–769. 1987.
32	Homesley HD, Bundy BN, Hurteau JA and Roth LM: Bleomycin, etoposide, and cisplatin combination therapy of ovarian granulosa cell tumors and other stromal malignancies: A Gynecologic Oncology Group Study. Gynecol Oncol. 72:131–137. 1999.
33	Brown J, Shvartsman HS, Deavers MT, et al: The activity of taxanes compared with bleomycin, etoposide, and cisplatin in the treatment of sex cord-stromal ovarian tumours. Gynecol Oncol. 97:489–496. 2005.
34	Pecorelli S, Wagenaar HC, Vergote IB, et al: Cisplatin (P), vinblastine (V) and bleomycin (B) combination chemotherapy in recurrent or advanced granulose(-theca) cell tumours of the ovary. An EORTC Gynaecological Cancer Cooperative Group study. Eur J Cancer. 35:1331–1337. 1999.
35	Pascale MM, Pugeat M, Roberts M, et al: Androgen suppressive effect of GnRH agonist in ovarian hyperthecosis and virilizing tumors. Clin Endocrinol (Oxf). 41:571–576. 1994.