An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report

David Eriandi Ginting; Putu Doster Mahayasa

doi:doi:10.11648/j.jgo.20200806.17

| Peer-Reviewed

An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report

David Eriandi Ginting, Putu Doster Mahayasa

Published in Journal of Gynecology and Obstetrics (Volume 8, Issue 6)

Received: 5 November 2020 Accepted: 17 November 2020 Published: 24 November 2020

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Ovarian steroid cell tumors are rare tumors of the ovary characterized by steroid cell proliferation. These sex-hormone secreting tumors raise many differential diagnoses related to hyperandrogenism. Although most of these tumors are benign and slow-growing, approximately 25 – 43% of cases are clinically malignant. Case: We herein report a case of 30 years old woman with ovarian steroid cell tumor, not otherwise specified (NOS) with primary infertility. The patient presented with hirsutism and abdominal enlargement due to massive ascites during hospital admission. The blood test result showed significantly increased CA-125. Transabdominal ultrasound revealed a 7.81 x 4.94 cm tumor of the left adnexa. The patient underwent left salpingo-oophorectomy and responded well to the surgery. Conclusion: This case report presents a unique case of ovarian steroid cell tumor, NOS with findings of massive ascites, hirsutism, and a high level of CA-125. The findings were never associated with this type of tumor. The steroid cell tumor and its ascites could mechanically irritate the mesothelium that causing overexpression of CA-125. Surgery remains as the first-line treatment of this case. Adjuvant chemotherapy should be done based on the histologic type of the tumor and its surgical stage. Tumor marker decreased after surgery was done and patient remains alive and free of disease after a period of 2 years.

Published in	Journal of Gynecology and Obstetrics (Volume 8, Issue 6)
DOI	10.11648/j.jgo.20200806.17
Page(s)	191-194
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Adnexal Mass, CA-125, Hirsutism

References

[1]	G Young RH, Clement PB & Scully RE 2004 Sex-cord, stromal, steroid cell and germ cell tumours of the ovary. In Sternberg’s Diagnostic Surgical Pathology, edn 4, pp 2579–2615.
[2]	Zhang X, Lu B: Ovarian steroid cell tumor, not otherwise specified (NOS): an unusual case with myelolipoma. Int J Gynecol Pathol, 2011; 30: 460–5.
[3]	Mehdi G, Ansari HA, Sherwani RK, Rahman K, Akhtar N. Ovarian Steroid Cell Tumour: Correlation of Histopathology with Clinico-pathologic Features. Pathology Research International, 2011; 1: 1-10.
[4]	Baloglu A, Bezircioglu I, Cetinkaya B, Karci L, Bicer M. Development of secondary ovarian lesions after hysterectomy without oophorectomy versus unilateral oophorectomy for benign conditions: a retrospective analysis of patients during a nine-year period of observation. Clin Exp Obstet Gynecol, 2010; 37: 299-302.
[5]	Outwater EK, Wagner BJ, Mannion C, McLarney JK, Kim B. Sex cord-stromal and steroid cell tumours of the ovary. Radiographics, 1998; 18 (6): 1523-46.
[6]	Cserepes E, Szucs N, Patkos P, Csapo Z, Molnar F, Toth M, et al. Ovarian steroid cell tumour and a contralateral ovarian thecoma in a postmenopausal woman with severe hyperandrogenism. Gynecol. Endocrinol, 2002; 16 (3): 213-6.
[7]	Dinc G, Saygin I, Kart C, Mungan S, Guven S, SedaGuvendagGuven E. A rare case of postmenopausal severe virilization: Ovarian steroid cell tumour, not otherwise specified. J Cases Obstet Gynecol, 2016; 3 (1): 19-21.
[8]	Rubido Valle CD, Fuente de la JLC, Martinez CS, Calvo LN, Escarda MR. Ovarian Steroid Cell Tumour Associated to Endometrial Hyperplasia and Presenting as Postmenopausal Vaginal Bleeding. Gynecol Obstet (Sunnyvale). 2015; 5 (9): 316.
[9]	Boyraz G, Selcuk I, Yusifli Z, Usubutun A & Gunalp S 2013 Steroid cell tumor of the ovary in an adolescent: a rare case report. Case Reports in Medicine 2013 527698.
[10]	Jiang W, Tao X, Fang F, Zhan S, Xu C. Benign and malignant ovarian steroid cell tumors, not otherwise specified: case studies, comparison, and review of the literature. Journal of Ovarian Research, 2013; 6: 1-5.
[11]	Deavers MT, Malpica A, Ordonez NG, Silva EG: Ovarian steroid cell tumors: an immunohistochemical study including a comparison of calretinin with inhibin. Int J Gynecol Pathol, 2003; 22: 162–7.
[12]	Musalhi K, Kindi MA, Ramadhan F, Rawahin T. Validity of Cancer Antigen-125 (CA-125) and Risk of Malignancy Index (RMI) in the Diagnosis of Ovarian Cancer. Oman Medical Journal, 2015; 30 (6): 428–34
[13]	Young TK, Sang WK, Yoon BS, Sung HK, Jae HK, Jae WK, Nam HC. An ovarian steroid cell tumor causing virilisation and massive ascites. Yonsei Medical Journal, 2007; 48: 142-6.
[14]	Park Y, Lee JH, Hong DJ, Lee EY, Kim HS. Diagnostic performances of HE4 and CA125 for the detection of ovarian cancer from patients with various gynecologic and non-gynecologic diseases. Clin Biochem 2011 Jul; 44 (10-11): 884-8.
[15]	Kammerer-Doak DN, Magrina JF, Nemiro JS, et al. Benign gynaecologic conditions associated with a CA-125 level >1,000 U/mL. A case report. J Reprod Med 1996; 41: 179–82.
[16]	Daoud E, Bodor G. CA-125 concentrations in malignant and non-malignant disease. Clin Chem 1991; 37: 1968–74.
[17]	Moss EL, Hollingworth J, Reynolds TM. The role of CA125 in clinical practice. J Clin Pathol. 2005; 58 (3): 308-12.
[18]	Kim YT, Kim SW, Yoon BS, Kim SH, Kim JH, Kim JW, Cho NH: An ovarian steroid cell tumor causing virilization and massive ascites. Yonsei Med J 2007, 48: 142–6.

Cite This Article

Plain Text BibTeX RIS

APA Style

David Eriandi Ginting, Putu Doster Mahayasa. (2020). An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report. Journal of Gynecology and Obstetrics, 8(6), 191-194. https://doi.org/10.11648/j.jgo.20200806.17

Copy | Download

ACS Style

David Eriandi Ginting; Putu Doster Mahayasa. An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report. J. Gynecol. Obstet. 2020, 8(6), 191-194. doi: 10.11648/j.jgo.20200806.17

Copy | Download

AMA Style

David Eriandi Ginting, Putu Doster Mahayasa. An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report. J Gynecol Obstet. 2020;8(6):191-194. doi: 10.11648/j.jgo.20200806.17

Copy | Download

@article{10.11648/j.jgo.20200806.17,
  author = {David Eriandi Ginting and Putu Doster Mahayasa},
  title = {An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {8},
  number = {6},
  pages = {191-194},
  doi = {10.11648/j.jgo.20200806.17},
  url = {https://doi.org/10.11648/j.jgo.20200806.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20200806.17},
  abstract = {Background: Ovarian steroid cell tumors are rare tumors of the ovary characterized by steroid cell proliferation. These sex-hormone secreting tumors raise many differential diagnoses related to hyperandrogenism. Although most of these tumors are benign and slow-growing, approximately 25 – 43% of cases are clinically malignant. Case: We herein report a case of 30 years old woman with ovarian steroid cell tumor, not otherwise specified (NOS) with primary infertility. The patient presented with hirsutism and abdominal enlargement due to massive ascites during hospital admission. The blood test result showed significantly increased CA-125. Transabdominal ultrasound revealed a 7.81 x 4.94 cm tumor of the left adnexa. The patient underwent left salpingo-oophorectomy and responded well to the surgery. Conclusion: This case report presents a unique case of ovarian steroid cell tumor, NOS with findings of massive ascites, hirsutism, and a high level of CA-125. The findings were never associated with this type of tumor. The steroid cell tumor and its ascites could mechanically irritate the mesothelium that causing overexpression of CA-125. Surgery remains as the first-line treatment of this case. Adjuvant chemotherapy should be done based on the histologic type of the tumor and its surgical stage. Tumor marker decreased after surgery was done and patient remains alive and free of disease after a period of 2 years.},
 year = {2020}
}

Copy | Download

TY - JOUR
T1 - An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report
AU - David Eriandi Ginting
AU - Putu Doster Mahayasa
Y1 - 2020/11/24
PY - 2020
N1 - https://doi.org/10.11648/j.jgo.20200806.17
DO - 10.11648/j.jgo.20200806.17
T2 - Journal of Gynecology and Obstetrics
JF - Journal of Gynecology and Obstetrics
JO - Journal of Gynecology and Obstetrics
SP - 191
EP - 194
PB - Science Publishing Group
SN - 2376-7820
UR - https://doi.org/10.11648/j.jgo.20200806.17
AB - Background: Ovarian steroid cell tumors are rare tumors of the ovary characterized by steroid cell proliferation. These sex-hormone secreting tumors raise many differential diagnoses related to hyperandrogenism. Although most of these tumors are benign and slow-growing, approximately 25 – 43% of cases are clinically malignant. Case: We herein report a case of 30 years old woman with ovarian steroid cell tumor, not otherwise specified (NOS) with primary infertility. The patient presented with hirsutism and abdominal enlargement due to massive ascites during hospital admission. The blood test result showed significantly increased CA-125. Transabdominal ultrasound revealed a 7.81 x 4.94 cm tumor of the left adnexa. The patient underwent left salpingo-oophorectomy and responded well to the surgery. Conclusion: This case report presents a unique case of ovarian steroid cell tumor, NOS with findings of massive ascites, hirsutism, and a high level of CA-125. The findings were never associated with this type of tumor. The steroid cell tumor and its ascites could mechanically irritate the mesothelium that causing overexpression of CA-125. Surgery remains as the first-line treatment of this case. Adjuvant chemotherapy should be done based on the histologic type of the tumor and its surgical stage. Tumor marker decreased after surgery was done and patient remains alive and free of disease after a period of 2 years.
VL - 8
IS - 6
ER -

Copy | Download

Author Information

David Eriandi Ginting

Obstetrics and Gynecology Department, Medical Faculty of Udayana University, Sanglah Hospital, Denpasar, Indonesia
Putu Doster Mahayasa

Reproductive Endocrinology and Infertilty Division, Obstetrics and Gynecology Department, Medical Faculty of Udayana University, Sanglah Hospital, Denpasar, Indonesia

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

David Eriandi Ginting, Putu Doster Mahayasa. (2020). An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report. Journal of Gynecology and Obstetrics, 8(6), 191-194. https://doi.org/10.11648/j.jgo.20200806.17

Copy | Download

ACS Style

David Eriandi Ginting; Putu Doster Mahayasa. An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report. J. Gynecol. Obstet. 2020, 8(6), 191-194. doi: 10.11648/j.jgo.20200806.17

Copy | Download

AMA Style

David Eriandi Ginting, Putu Doster Mahayasa. An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report. J Gynecol Obstet. 2020;8(6):191-194. doi: 10.11648/j.jgo.20200806.17

Copy | Download

@article{10.11648/j.jgo.20200806.17,
  author = {David Eriandi Ginting and Putu Doster Mahayasa},
  title = {An Ovarian Steroid Cell Tumor with High Levels of CA-125 in Sanglah General Hospital: A Rare Case Report},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {8},
  number = {6},
  pages = {191-194},
  doi = {10.11648/j.jgo.20200806.17},
  url = {https://doi.org/10.11648/j.jgo.20200806.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20200806.17},
  abstract = {Background: Ovarian steroid cell tumors are rare tumors of the ovary characterized by steroid cell proliferation. These sex-hormone secreting tumors raise many differential diagnoses related to hyperandrogenism. Although most of these tumors are benign and slow-growing, approximately 25 – 43% of cases are clinically malignant. Case: We herein report a case of 30 years old woman with ovarian steroid cell tumor, not otherwise specified (NOS) with primary infertility. The patient presented with hirsutism and abdominal enlargement due to massive ascites during hospital admission. The blood test result showed significantly increased CA-125. Transabdominal ultrasound revealed a 7.81 x 4.94 cm tumor of the left adnexa. The patient underwent left salpingo-oophorectomy and responded well to the surgery. Conclusion: This case report presents a unique case of ovarian steroid cell tumor, NOS with findings of massive ascites, hirsutism, and a high level of CA-125. The findings were never associated with this type of tumor. The steroid cell tumor and its ascites could mechanically irritate the mesothelium that causing overexpression of CA-125. Surgery remains as the first-line treatment of this case. Adjuvant chemotherapy should be done based on the histologic type of the tumor and its surgical stage. Tumor marker decreased after surgery was done and patient remains alive and free of disease after a period of 2 years.},
 year = {2020}
}

Copy | Download