Ovarian Endometrioid Adenocarcinoma with Functioning Stroma Accompanied with Endometrial Endometrioid Adenocarcinoma: Immunohistochemical Study and Literature Review

作     者：Takashi Yuri Tomomi Mizokami Yuichi Kinoshita Katsuhiko Yoshizawa Katsuhiko Yasuda Airo Tsubura 

作者机构：Department of Pathology II Kansai Medical University Divisions of Obsterics and Gynecology Kansai Medical University Osaka Japan 

出 版 物：《Open Journal of Pathology》 (病理学期刊（英文）)

年 卷 期：2013年第3卷第4期

页      面：150-155页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Ovarian Cancer Endometroid Adenocarcinoma Functioning Stroma Immunohistochemistry Estrogen Etradiol 

摘      要：Background: The ovarian tumors with functioning stroma are defined by the morphological presence of endocrine active cells in stroma, and the clinical, biochemical or pathological evidence of endocrine function. Case Report: The ovarian endometrioid adenocarcinoma with functioning stroma accompanied with endometrial endometrioid adenocarcinoma was found in 64-year-old post-menopausal woman complaining abnormal genital bleeding and mammary distention. Her preoperative serum 17?-estradiol level was high (53.2 pg/ml) while human chorionic gonadotropin (hCG) level was within normal limit. Her right ovary with 8.8 × 5.3 cm in size and tan-yellow in color mostly consisted of solid tumor. Histologically, tumor was composed of estrogen receptor (ER)- and progesterone receptor (PgR)-positive, and androgen receptor (AR)-negative cancerous endometrial cells with aggregates of vacuolated foamy stromal cells resembling luteinized cells. These stromal cells contained lipid droplets, and was immunopositive for α-inhibin and 17?-estradiol. After surgery, serum 17?-estradiol level decreased and became normal (14.2 pg/ml). These findings indicate the production of steroid hormone (17?-estradiol) from the foamy stromal cells and may be correlated with the clinical symptoms. Furthermore, ER- and PgR-positive endometrial endometrioid adenocarcinoma developed synchronously. However, ovary and uterus were totally immunonegative for human chorionic gonadotropin (hCG). Four other cases from the literature including ours are reviewed. Conclusion: Cancer cells were positive for ER and PgR in both ovary and uterus responded to steroid hormone produced by foamy stromal cells, which played a role in proliferation and progression of ovarian and endometrial endometrioid adenocarcinoma, respectively.