Gynandroblastoma of the Ovary

Abstract

This is the report of an ovarian tumor in a 59-year-old female who showed hirsutism for 30 years and had had post-menopausal vaginal bleeding for approximately 1 month. Pelvic examination was normal. One ovary had been previously removed for an ectopic pregnancy in 1929 She had had 6 pregnancies that went to full term, 1 of which resulted in a stillborn fetus and 5 in living children which she nursed without difficulty. Menstrual periods had been irregular, with menopause at age 46. Curettage of the uterus revealed hyperplasia of the endometrium with some areas that were interpreted as carcinoma in situ. A hysterectomy and salpingo-oophorectomy was performed and a 6 mm ovarian tumor was found to contain a mixture of granulosa-theca cell elements along with tubular elements and interstitial cells of Leydig. Post-operative hormone studies revealed normal 17-ketosteroids and 17-hydroxycorticoids. A review of the literature reveals that there have been 39 possible gynandroblastomas reported since Robert Meyer''s original description in 1930 Of these, 31 have been rejected in critical review by previous authors. It is concluded that more observations will be necessary to establish the clinical criteria for diagnosis of this tumor. The morphologic criteria are more clearly defined.