Androblastoma of an ovary
Androblastoma of an ovary – a rare gormonprodutsiruyushchy tumor of an ovary. It is diagnosed mainly at young age. It is shown by developing of an acne, disappearance of periods, change of a figure on men's type, a girsutizm, a posterization of a voice and increase in a clitoris. Premature isosexual development (at teenagers) or emergence of bloody allocations from a vagina is less often observed (at women of climacteric age). Androblastoma of an ovary more often is high-differentiated and proceeds is good-quality. In some cases perhaps malignant current. The diagnosis is exposed on the basis of complaints, the yielded general and gynecologic survey and results of additional researches. Treatment is quick.
Androblastoma of an ovary
Androblastoma of an ovary – the ovary tumor emitting male sex hormones. According to various data, makes 0,2-0,4% of total of tumors of ovarialny fabric. Usually occurs at teenage girls and young women. Can be high-differentiated, intermediate or low-differentiated. More often the high-differentiated ovary androblastoma with rather good-quality current come to light. More rare, usually at advanced age or at the low level of a differentiation of cages, the malignant current is observed. After removal of an androblastoma of an ovary the excess growth of hair on a body stops, the ovulyatorny cycle is restored, the figure gets female outlines again. At the high-differentiated tumors the forecast favorable. Diagnostics and treatment are performed by experts in the field of oncology and gynecology.
Etiology and features of a structure of an androblastoma of an ovary
The reasons of development of an androblastoma of an ovary are unknown. It is considered that such tumors are formed of the embryonic remains of a male part of a gonad under the influence of certain changes of gipotalamo-hypophysial system or in connection with features of interaction of lyuteineziruyushchy hormone with the corresponding receptors in ovaries, however, what changes cause growth of similar new growths – so far it was not succeeded to establish. Hereditary predisposition is not revealed.
Androblastoma of an ovary treats group of the viriliziruyushchy tumors developing from mesenchyma fabric. Usually happens single and unilateral, bilateral tumors meet less than in 1% of cases. Taking into account the level of a differentiation of cages allocate three options androblasty an ovary: high-differentiated, intermediate and low-differentiated. There are four look high-differentiated androblasty: tubulyarny adenoma, an androblastoma with accumulation of lipids, a leydigoma, a tumor from cages of Leydiga and Sertoli. Tubulyarny adenoma and an androblastoma of an ovary with accumulation of lipids consist of Sertoli's cells. The effect of a virilization is more provided with cages of Leydiga, effect of feminization (at premature isosexual development) – Sertoli's cells.
Ovary androblastoma symptoms
The disease is usually diagnosed aged up to 40 years, the peak of incidence falls on the third decade of life. In some cases children suffer. Development of an androblastoma of an ovary is followed by emergence of signs of a muskulinization. In 2/3 cases there is a girsutizm, in 1/3 cases – . Approximately within half a year at the patient become poor, and then periods stop, the figure changes, there are an acne and excess pilosis.
Usually the disease proceeds in two stages. At the first stage of an androblastoma of an ovary (a defeminization stage) develops , and then . Mammary glands atrophy, the fatty deposits giving to the woman's figure characteristic rotundity and softness disappear. At the second stage of an androblastoma of an ovary (a masculinization stage) the clitoris increases, there is excess pilosis. The voice becomes more rough. Some patients have high temples in parietal and frontal areas.
Ovary androblastoma cases in a combination are described by a giperestrogenemiya. At girls premature puberty according to a floor begins. At women of reproductive age violations of a menstrual cycle are noted, patients in a postmenopause have bloody allocations from a genital tract. This option of development of a disease is not typical for an androblastoma and meets rather seldom.
Diagnostics of an androblastoma of an ovary
The diagnosis of an androblastom of an ovary is established on the basis of complaints, the anamnesis, the yielded external and gynecologic survey and results of tool researches. Usually patients address the gynecologist or the endocrinologist with complaints to lack of periods, excess pilosis and change of appearance. At the general survey of patients with androblastomy an ovary the atrophy of mammary glands, a girsutizm and change of a figure on men's type is found. At gynecologic survey the hypertrophy of a clitoris and the painless, mobile, smooth opukholevidny formation of a dense consistence located on the right or to the left of a uterus comes to light.
Ultrasonography of genitals demonstrates existence of opukholevidny formation of the cystous, solid or cystous and solid type with accurately expressed capsule and a non-uniform internal structure which is characterized by alternation hyper - and gipoekhogenny sites. When performing blood tests on hormones at patients with androblastomy an ovary increase in level of testosterone, decrease in level of lyuteineziruyushchy and follikulstimuliruyushchy hormone comes to light. Level of a degidroepiandrosteron is normal or is slightly increased.
Treatment and the forecast at an ovary androblastoma
Treatment is surgical. The volume of surgery is defined with age of the patient. To the patients of reproductive age suffering androblastomy an ovary usually carry out a unilateral adneksektomiya. In the course of operation carry surely out audit of the second ovary. At increase in the size of an ovary cut body, carry out an intraoperative histologic research for an exception of the second tumor. At post-climacteric age carry usually out pan-hysterectomyby - hysterectomy with removal of appendages.
At a malignant current, low level of a differentiation and a rupture of the capsule of an androblastoma of an ovary of average degree of a differentiation radical surgical intervention with removal of a uterus is shown regardless of age of the patient. In the postoperative period appoint chemotherapy and radiation therapy, however it is still difficult to estimate efficiency of the combined therapy at malignant androblastoma of an ovary because of a small amount of observations.
The forecast is usually favorable. 90-95% of patients with high-differentiated androblastomy an ovary overcome a ten-year threshold of survival. At the malignant tumor diagnosed at the I stage, and use of radiation therapy in the postoperative period five-year survival according to some information makes 75%. At an initiation of treatment at II and III stages decrease in five-year survival to 50% is noted. Characteristic of an androblastoma of an ovary is the early retsidivirovaniye. 60% of a recurrence come to light within the first year after surgical intervention. Signs of a virilization disappear within 1-1,5 years after operation. The hypertrophy of a clitoris remains during all life.