The Tekoma | Hormonal-active tumors of the ovaries
The

Tecoma

For the first time, Loffler and Priesel (1932) were singled out as a separate nosological unit. The frequency of the current among ovarian tumors fluctuates, according to the literature, in the range of 1.03-4% (ID Nechaeva, 1957, BI Zheleznov, 1958, MF Glazunov, 1961, LA Solovieva, 1963, and others). As already noted above, most teek develops in women in the menopause period.

Clinical signs of tekoma in women in menopause are mostly characterized by the presence of a feminizing effect to some extent, that is, the disappearance of phenomena of age-related atrophy of the external and internal genital organs, the juiciness of the mucous membranes of the vagina and cervix, the increase in the size of the uterus, the occurrence of bleeding (M. F. Glazunov, 1952; EN Androsova, 1955; AB Gillerson, 1957; BM Zheleznov, 1958; PI Sheinin, 1958; ID Nechaeva, 1966; Dinnerstein, O ' Leary, 1968, and others). The dimensions of the oecular tekoma itself can vary from a non-palpable tumor to an adult's head and more. The largest weight of the remote tecoma was 73.6. Pound (33 kg) (Reiner, 1948).

Among the examined patients, tekoma was found in 25 women. At the same time, in 4 women, the presence of the Tecomium was detected only after repeated admission in the period from two months to 3 years. The sizes of tumors were different - from a large node to a microtec. In particular, in one patient who was operated on during repeated admission for bleeding in menopause, the presence of two micro-beaks in an unimproved ovary was revealed in the study of all micropreparations of operated patients; in due time these microtekomas have not been revealed by the pathomorphologist.

The

It should be noted that in both patients with ovarian micro-tekoma, a pronounced estrogenic effect was observed in the form of glandular endometrial hyperplasia and bleeding in menopause. The smallest diameter of the tecoma, accompanied by the estrogen effect, was 1.5 cm from the number observed by Glazunov (1961). However, as Haines and Taylor (1962) point out, in such small tumors luteinization of cells is more pronounced than in large tumors; according to the authors, there is a correlation between the small potential of the tumor to growth and its large hormonal activity.

In two observations, the patients had a combination of Tecomium with Brenner's tumor.

Of 25 patients in 20 in the endometrium, a proliferative process was found: in 2 - cancer of the uterus body, in 4 - adenomatosis, in 14 - glandular hyperplasia or polyposis of the endometrium. In the remaining five cases, in two women, the endometrium was in a state of atrophy, in one it was impossible to assess its condition, and in two it was not examined. It is noteworthy that the clinical manifestations of hormonal activity of tumors (postmenopausal uterine bleeding) were observed in women with ovarian tecoma at different frequencies; in some cases, bleeding was several times a year, in others - once for several years. Similarly, the manifestations of feminization were expressed. The data of these observations confirm the opinion of PI Sheinin (1968), AB Gillerson (1963, 1965, 1966), LA Solovieva (1969), and Avar and Kubinyi (1964) that the production of hormones in the tumor and the reactivity of the body can vary with the same woman.

Tecoma is a tumor consisting of teka cells. It occurs very rarely. It is formed from the ovary mesenchyme. More than half of the cases occur during the menopause. Tumor cells produce estrogens and androgens. For the most part, the tumor is benign. Not all tekomes exhibit endocrine activity. The development of a tumor can be facilitated by x-ray irradiation.

In a sexually mature woman, a tecoma may be accompanied by amenorrhea or dysmenorrhea. Excess androgen can lead to virilization. There may be hypertrophy of the mammary glands. The uterus usually increases.

If the tumor has developed after the onset of menopause, there may be a seeming "return of youth" with the resumption of menstruation and sexual desire and the disappearance of climacteric phenomena (hot flashes, sweating, etc.).

When a tumor is combined with a carcinoma of the uterus and the resultant ascites and hydrothorax, a symptom complex, known as Meigs syndrome, appears (see).

With tecoma, endometrial hyperplasia is noted. A histological examination of the uterus is necessary.

Treatment operative.