Question
A 48-year-old female underwent total hysterectomy with bilateral salpingo-oophorectomy. The surgical specimen revealed a solid ovarian tumor, and histology confirmed it as a thecoma-fibroma. Which of the following statements is most appropriate regarding this condition?
| A. |
20% of such tumors are bilateral.
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| B. |
Endometrial hyperplasia is often associated.
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| C. |
It is always associated with gross ascites.
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| D. |
It is derived from germ cells.
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Show Answer
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Correct Answer » B
Explanation
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Thecoma and fibroma belong to the sex cord-stromal group of ovarian tumors, not the germ-cell group. Thecoma may have estrogenic activity, and estrogen stimulation can result in endometrial hyperplasia and, in some cases, endometrial carcinoma. The supplied material specifically states that granulosa-theca cell tumors secrete estrogen and are associated with endometrial hyperplasia, menorrhagia, or carcinoma in adults.
Why the other options are incorrect
A. Approximately 20% of these tumors are bilateral.
Incorrect. Bilaterality is not the characteristic feature being tested here.
B. Endometrial hyperplasia is often associated.
Correct. Estrogen-secreting sex cord-stromal tumors, particularly theca/granulosa-theca tumors, can cause endometrial hyperplasia.
C. These tumors are always associated with gross ascites.
Incorrect. Ascites is classically associated with ovarian fibroma as part of Meigs syndrome, but it is not invariably present. Meigs syndrome consists of ovarian fibroma, ascites, and pleural effusion.
D. These tumors are derived from germ cells.
Incorrect. Thecoma and fibroma are sex cord-stromal tumors. Germ-cell tumors include dysgerminoma, yolk sac tumor, embryonal carcinoma, choriocarcinoma, and teratoma.
