Ovarian theca cell tumors

　　Ovarian theca cell tumors originate from special mesenchymal ectodermal tissue in the ovarian stroma, differentiate into theca cell cells to form tumors. Some researchers have found that theca cell tumors have Trisomy 12 (Trisomy 12) found in other sex cord stromal tumors through cell genetic analysis, and theca cell tumors also have Trisomy 4 (Trisomy 4), and it is believed that the latter is the second tumor gene of theca cell tumors.

　　Ovarian theca cell tumors are prone to合并flavonization theca cell tumors. Among the 6 patients in the statistics, intestinal obstruction occurred. Operative exploration found that the peritoneal lesions were thickened by fibrous tissue by 4-5mm, and they could also involve the omentum, small intestine, and other places. Microscopic examination showed that the peritoneal lesions were composed of proliferative fibroblasts and smooth muscle cells divided by collagen fibers or fibrous tissue, with chronic inflammatory cell infiltration. Among the ovarian lesions, 3 cases were solid masses with diameters of 12-31cm, and the other 3 ovaries were only slightly enlarged in nodular form. Microscopic examination showed all were flavonization theca cell tumors. One patient died of pulmonary embolism 2 months after surgery, and 4 follow-up patients had no tumor recurrence from 8 months to 6 years after surgery. Similar cases have not been reported in China, but they should attract the attention of clinical physicians. For patients with ovarian solid tumors with symptoms such as ascites, intestinal obstruction, and endocrine disorders, one should be vigilant about the existence of rare sclerosing peritonitis.

　　Ovarian theca cell tumors have significant endocrine function, and therefore, clinical patients may exhibit hyperestrogenism or masculinization. The clinical manifestations are as follows.
　　1, Increased estrogen:Due to the secretion of estrogen by the tumor, the endometrium, as the target organ, often leads to proliferative lesions or carcinogenesis. Common clinical symptoms include irregular vaginal bleeding, menorrhagia, amenorrhea, and postmenopausal bleeding.
　　2, Masculinization:About 2% of cases show masculinization, with an increase in blood testosterone levels. This usually occurs when theca cell tumors undergo flavonization and cystic changes. Clinically, patients may present with a series of symptoms such as hirsutism, acne, hoarse voice, clitoral enlargement, breast atrophy, and low estrogen levels. These symptoms gradually improve and disappear after tumor resection.
　　3, Others:Abdominal discomfort and bloating. Occasionally, tumor torsion can lead to acute abdominal pain. Since young patients with theca cell tumors are rare, there are few reports of concurrent pregnancy, but when it occurs, the tumor is prone to rupture.

　　The etiology of ovarian theca cell tumors is not yet clear, and there are currently no targeted preventive measures. High-risk groups need to do regular physical examinations, regular screenings, early detection, and early treatment, with a generally good prognosis.

　　The diagnosis of ovarian theca cell tumors can be made based on the patient's clinical manifestations, symptoms, and the following related examination results.
　　1. Laboratory examination:Hormonal level examination, tumor marker examination.
　　2. Other auxiliary examinations:Abdominal ultrasound, histopathological examination, laparoscopic examination.

　　The dietary taboos for patients with ovarian theca cell tumors are as follows:

　　1. Eat foods with hemostatic and anti-ulcer effects, such as loofah, eggplant, luffa, banana, duck egg, malan head, peach kernel, vinegar, toad, water chestnut, jellyfish.

　　2. Eat foods that can prevent and treat the side effects of chemotherapy and radiotherapy, such as kiwi, asparagus, rose, shark steak, grass carp, crucian carp, eel, reed, sardine.

　　3. Eat more foods with anticancer effects, such as rose, asparagus, soybean paste, olive, pagoda flower, dandelion, chicken gizzards, eggplant,螺蛳, mung bean.

　　4. Avoid irritants.

　　5. Avoid smoking, alcohol, and spicy刺激性 foods.

　　6. Avoid greasy, fried, moldy, and salted foods.

　　7. Avoid warm foods such as mutton, chive, dog meat, pepper, ginger, cassia, etc.

　　Due to the stimulation of estrogen, patients with ovarian theca cell tumors often have varying degrees of hyperplastic lesions, even endometrial cancer, so the treatment of uterine lesions should also be considered in the treatment.
　　If there is no uterine lesion, for women in adolescence and those who have not given birth, general removal of the affected adnexa is performed. Even if there are hyperplastic lesions or atypical hyperplasia in the endometrium of this group of patients, only the affected adnexa can be removed. Endocrine therapy can be performed after surgery, and regular diagnostic curettage can be carried out to strive to solve the problem of fertility under strict supervision. Postmenopausal women should undergo total hysterectomy and bilateral adnexectomy.
　　If accompanied by endometrial cancer, the surgical scope should be appropriately expanded according to the clinical stage of endometrial cancer. For those with malignant tumors or metastasis, ovarian cancer cell reduction surgery should be performed, followed by chemotherapy or radiotherapy.