OVERVIEW

What is ovarian thecoma? Is it benign or malignant?

Ovarian thecoma is a type of sex cord-stromal tumor among ovarian non-epithelial tumors. Apart from imaging abnormalities, patients typically lack specific clinical manifestations.

Ovarian thecomas are generally rarely malignant but may be associated with endometrial cancer, leading to symptoms such as abdominal pain or irregular vaginal bleeding, which require attention. Overall, the prognosis is better than that of ovarian epithelial cancer.

Is ovarian thecoma common in daily life?

Ovarian sex cord-stromal tumors are rare, with ovarian thecomas accounting for only 0.5%–1% of all ovarian tumors.

Which populations are more likely to develop ovarian thecoma?

Ovarian thecoma predominantly occurs in postmenopausal women, with an average onset age of 53. About 80% of cases develop after menopause, while prepubertal onset is rare. The incidence rates in individuals under 20 and 30 years old are only 3% and 10%, respectively.

SYMPTOMS

What are the common clinical manifestations of ovarian thecoma?

The clinical manifestations of ovarian thecoma are similar to those of other ovarian tumors, mainly presenting as pelvic masses detected during imaging examinations or physical examinations. These masses are mostly unilateral, cystic or cystic-solid, and lack specific features.

If combined with endometrial cancer, symptoms such as abdominal pain and irregular vaginal bleeding may occur. Thecoma cells can produce estrogen and exhibit endocrine activity. When the tumor is large, excessive estrogen production may lead to pleural or peritoneal effusions.

CAUSES

What are the causes of ovarian thecoma?

Some scholars suggest that ovarian thecoma originates from the ovarian medulla, but the exact causes remain unclear. It is generally believed to be associated with endocrine factors, environmental influences, and other elements. Viruses, hormones, and genetic factors are considered high-risk factors but do not directly cause the disease.

Is ovarian thecoma hereditary?

There is currently no definitive conclusion on whether ovarian thecoma is hereditary.

Is ovarian thecoma contagious?

Ovarian thecoma typically does not involve bacterial, viral, or parasitic infections and is therefore not contagious.

DIAGNOSIS

What tests are generally required for the diagnosis of ovarian thecoma?

• Serum tumor marker tests: To differentiate from other hormone-producing ovarian tumors.

• Imaging tests such as pelvic ultrasound, pelvic MRI, and chest X-ray can detect adnexal masses, determine their size, shape, and blood flow signals, and assess the presence of abdominal or pleural effusion.

• Gynecological examination: The adnexal mass feels firm, solid, and smooth to the touch.

• The final diagnosis is based on pathological examination of surgical specimens.

What diseases should ovarian thecoma be differentiated from?

The diagnosis of ovarian thecoma should be differentiated from the following conditions:

• Other ovarian tumors: Such as ovarian epithelial tumors and other types of sex cord-stromal tumors, distinguished through postoperative pathological diagnosis.

• Subserosal uterine fibroids or broad ligament fibroids. These can be differentiated based on intraoperative findings and postoperative pathology.

TREATMENT

Which department should be consulted for ovarian thecoma?

Visit the gynecology or obstetrics and gynecology department. Postoperative chemotherapy or radiotherapy may require referral to the oncology department.

How should ovarian thecoma be treated?

Surgery is the preferred treatment for thecoma. All women with thecoma should undergo endometrial sampling before or during surgery to rule out concurrent endometrial cancer. The specific surgical approach depends on the patient's age, fertility status, tumor pathology, and presence of uterine lesions.

• For those desiring fertility, ovarian tumor enucleation or unilateral adnexectomy may be performed;

• For premenopausal women without fertility needs, ovarian tumor enucleation or unilateral adnexectomy is generally recommended;

• For postmenopausal patients, total hysterectomy with bilateral adnexectomy may be performed to prevent secondary conditions such as endometrial cancer;

• For elderly or frail patients, less invasive procedures like ovarian tumor enucleation or unilateral adnexectomy may be considered.

DIET & LIFESTYLE

What should patients with ovarian thecoma pay attention to in daily life?

Ovarian thecoma is rarely malignant and mostly benign. If pathology confirms it as benign after resection, no further treatment is needed—regular gynecological check-ups suffice. If combined with other malignant tumors, subsequent treatment plans (such as radiotherapy or chemotherapy) should be determined based on postoperative pathology results.

PREVENTION

Can ovarian thecoma be prevented?

The exact pathogenesis of ovarian thecoma is not yet fully understood, and there is no effective method to prevent its occurrence. Regular gynecological check-ups are recommended for early detection and treatment.