Ovarian gynandroblastoma

　　The etiology of ovarian androgenic blastoma is not yet clear. Most of the tumors are unilateral, with a diameter of 6-20cm, most of which are less than 6cm. They are oval, with or without capsule, and the surface is smooth. The cut surface is gray yellow, gray powdery, or brown, mostly solid, and may also be multicystic or cystic. Microscopic examination shows that the tumor contains supporting cells, stromal cells, and well-structured granulosa cells and theca cells containing Call-Exner bodies. These sex cord-stromal components are intermingled in the tumor rather than independent components.

　　Large ovarian androgenic blastoma may be complicated with torsion of the pedicle, leading to hemorrhage and necrosis, causing severe abdominal pain. At the same time, it may also cause difficulties in urination and defecation. Therefore, once symptoms are found, treatment should be given in a timely manner.

　　The clinical symptoms of ovarian androgenic blastoma are atypical, mainly manifested by abdominal mass and endocrine disorders in two aspects.

　　I. Pelvic mass Androgenic blastoma mostly occurs in unilateral ovaries, with an average diameter of less than 6cm. Through careful pelvic examination and auxiliary examinations such as B-ultrasound, most solid occupying lesions in the adnexal area can be detected.
　　II. Endocrine changes Since the tumor is composed of granulosa-theca components and supportive-interstitial components, tumor cells can secrete estrogens as well as androgens, resulting in various clinical manifestations of endocrine changes.
　　1. Estrogenic influence: Symptoms such as menorrhagia, postmenopausal bleeding, and clinical symptoms such as uterine enlargement and endometrial hyperplastic pathological changes may occur.
　　2. Androgenic influence: Symptoms such as amenorrhea, breast atrophy, hirsutism, hoarse voice, clitoral hypertrophy, and other masculinization symptoms may appear in some patients.
　　3. There are also cases where both male and female symptoms are present or appear in turn.

　　At present, there are no targeted preventive measures for ovarian androgenic blastoma. High-risk groups should do regular physical examinations, early detection, and early treatment. After treatment, attention should be paid to follow-up monitoring of tumor markers to prevent recurrence.

　　Due to the rarity of the tumor, it is difficult to differentiate the clinical symptoms of endocrine disorders from other types of ovarian sex cord-stromal tumors. Preoperative diagnosis is very difficult. The presence of inhibin (inhibin) and MIC2 antibodies in serum can suggest the existence of adult-type or juvenile granulosa cell tumors, which may be beneficial for preoperative analysis and diagnosis. Commonly used clinical examination methods include:
　　1. Laboratory examination:Hormone level examination.
　　2. Other auxiliary examinations:Laparoscopic examination, abdominal ultrasound, and histopathological examination.

　　The diet of patients with ovarian teratoma should be rich in nutrition and delicious, and the main points of attention include the following aspects.

　　1. Staple foods should be mainly bread, steamed buns, dumplings, and other staple foods.

　　2. Only eat a small amount of lean pork, beef, chicken breast, fish, shrimp, liver paste with few tendons, and it must be minced and cooked, or cooked until soft and then minced.

　　3. Do not fry eggs.

　　4. Peel fruits, do not eat dry nuts such as peanuts, almonds, walnuts, etc.

　　5. Eat more foods with anti-tumor effects: horseshoe crab, sea horse, dragon pearl tea, hawthorn.

　　6. Hemorrhage: It is advisable to eat goat blood,螺蛳, cuttlefish, conch, spinach, lotus root, malan head, mushroom, stone ear, hickory, persimmon cake.

　　7. Infection: It is advisable to eat eel, clam, needlefish, carp, kelp, celery, water snake, sesame, buckwheat, toon, rapeseed, red bean, mung bean.

　　8. Abdominal pain, bloating: It is advisable to eat pork kidney, myrica, hawthorn, citrus cake, walnut, chestnut.

　　9. Avoid刺激性食物 such as scallion, garlic, chili, cinnamon, etc.

　　10. Avoid greasy, fried, moldy, and preserved foods.

　　11. Avoid warm foods such as mutton, dog meat, chive, pepper, etc.

　　The treatment of ovarian teratoma varies according to the patient's age and reproductive status and can be carried out by different surgical methods such as the removal of the affected adnexa, the removal of the affected adnexa and uterus, or the removal of both adnexa and uterus.
　　Currently, ovarian teratoma is considered a benign tumor because the tumor shows benign morphological features and there are no reports of clinical recurrence or metastasis. When there is a large amount of granulosa cell tumor component in the tumor composition (regardless of juvenile or adult type), as granulosa cell tumors belong to low-grade malignant tumors, there is a possibility of early (juvenile) or late (adult) recurrence. Long-term close follow-up is required for these patients, and efforts should be made to monitor with plasma tumor markers such as inhibin and MIC2. Due to the few cases at present and the lack of long-term follow-up reports, further in-depth observation and research are needed for the prognosis of the tumor, and a definitive conclusion can only be drawn in the future.