Luteinized thecoma associated with sclerosing peritonitis - Conservative surgical approach followed by corticosteroid and GnRH agonist treatment - a case report

R. Schonman, Z. Klein, E. Edelstein, B. Czernobilsky, A. Fishman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Luteinized thecoma of the ovary associated with sclerosing peritonitis is a rare tumor that has no standard definitive treatment regimen. Case: A 25 year-old patient diagnosed with luteinized thecoma and sclerosing peritonitis in the omentum. The patient received high dose corticosteroids (IV Hydrocortisone 500 mg/d) and GnRH agonist (IM Leuprolide 3.75 mg) in order to achieve ovarian suppression and relief of the clinical peritonitis. She was re-admitted two weeks later due to bowel obstruction which was treated conservatively. The steroid regimen was continued by oral intake for 5 weeks with complete remission of the peritonitis related symptoms. The bilateral enlarged ovarian tumor-like solid was the prominent finding in consecutive ultrasound exams with no decrease in size despite of the above mentioned protocol. Thus, the patient was re-operated for exploration and biopsies of the ovary and the pathology report showed no evidence of remnant disease in the ovary, or in the peritoneum. Completing follow-up of 15 months since the last operation, the patient is asymptomatic. She conceived spontaneously and currently is in her 24th week of a normal pregnancy. Conclusion: This is the first case report in the English literature of a successful medical conservative treatment of a young patient with luteinized thecoma associated with sclerosing peritonitis that led to complete relief of the symptoms and allowed fertility preservation.

Original languageEnglish
Pages (from-to)540-543
Number of pages4
JournalGynecologic Oncology
Volume111
Issue number3
DOIs
StatePublished - Dec 2008
Externally publishedYes

Keywords

  • Sclerosing peritonitis
  • Thecoma

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