Clinical synopsis
Age at diagnosis: Usually > 40 years old (65% post-menopausal)
+/- hormonally active (estrogenic or androgenic)
usually benign
unilateral (in 90% of cases)
Macroscopy:
well defined, firm, solid, covered by intact ovarian serosa;
usually yellow.
Microscopy
The tumor cells have abundant pale cytoplasm.
Hyaline plaques are conspicuous.
spindle cells
- moderate pale cytoplasm containing lipid droplets
- central nuclei
stroma
- collagen deposition
- focal hyaline plaque formation
- +/- heavily calcified
- +/- prominent stromal hyperplasia (hyperthecosis)
fat stains + (on fresh/frozen tissue)
- Oil red O +
- Sudan black + (fat stains)
silver stains
- reticulin fibers surrounding individual cells
Variants
luteinized thecoma
- thecoma with steroid hormone secreting cells
- edema
- focal mitotic activity
Leydig cell containing thecoma
- cytoplasmic Reinke crystalloids
Cytogenetics
trisomy 12
tetrasomy 12 (11148462)
See also
ovarian sex cord-stromal tumors
INHA