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Rare Presentation of a Rare Tumour: Case Report of Sclerosing Stromal Tumour with Meig’s Syndrome and Raised Serum Cancer Antigen 125.
EP30468
Poster Title: Rare Presentation of a Rare Tumour: Case Report of Sclerosing Stromal Tumour with Meig’s Syndrome and Raised Serum Cancer Antigen 125.
Submitted on 18 Aug 2019
Author(s): Kushal Joshi, Tauseef Ashraf
Affiliations: University Hospitals of Leicester and Pilgrim Hospital, Boston
Poster Views: 215
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Poster Information
Abstract: Introduction

Ovarian sex cord-stromal tumours constitute approximately 8% of all primary ovarian neoplasms. Sclerosing stromal tumour (SST), a rare sub-type of ovarian sex-cord stromal tumour, accounts for 2% to 6% of tumours in this group.1 SST are benign tumours that most often affect women in the second and third decade of life. It usually presents with menstrual irregularities and pelvic pain.2 SST presenting with Meigs’ syndrome with raised CA 125 is extremely rare and only 6 previously reported cases in the literature.

Case Report

We present the seventh case in a 41-year-old female who presented with massive ascites and pleural effusion which were drained for symptomatic relief. Her CA 125 was raised (1494 kU/L). She underwent an uneventful surgical resection. The histopathological and immunohistochemical appearance confirmed SST. Surgical resection is curative and no cases of recurrence exist in the literature.

Discussion

Although the diagnosis of SST is based on histology findings, imaging has an important role in distinguishing between benign and malignant lesions pre-operatively in young women who wish to preserve their fertility. This determines the extent of surgical resection carried out. We review the previously known cases of SST and discuss their ultrasound, CT and MRI features. On T2W imaging, SST is a predominantly cystic hyperintense lesion with a heterogeneous solid component of intermediate to high signal intensity in the periphery. Dynamic contrast enhanced MRI features demonstrate an early peripheral enhancement with centripetal progression.3,4 These characteristics may be useful in distinguishing it from other benign and malignant tumours of the ovary. We also discuss possible mechanisms of Meigs’ Syndrome and raised CA 125 in SST.
Summary: Rare Presentation of a Rare Tumour: Case Report of Sclerosing Stromal Tumour with Meig’s Syndrome and Raised Serum Cancer Antigen 125.References: 1. Bairwa S, Satarkar RN, Kalhan S, Garg S, Sangwaiya A, Singh P. Sclerosing Stromal Tumor: A Rare Ovarian Neoplasm. Iran J Pathol. 2017;12(4):402-5.

2. Ozdemir O, Sarı ME, Sen E, Kurt A, Ileri AB, Atalay CR. Sclerosing stromal tumour of the ovary: A case report and the review of literature. Niger Med J. 2014 Sep;55(5):432-7.

3. Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 2002 Nov-Dec;22(6):1305-25.

4. Zhao SH, Li HM, Qiang JW, Wang DB, Fan H. The value of MRI for differentiating benign from malignant sex cord-stromal tumors of the ovary: emphasis on diffusion-weighted MR imaging. J Ovarian Res. 2018 Aug 30;11(1):73.
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