CASE REPORT OVARIAN CLEAR-CELL CARCINOMA PRODUCING ESTRADIOL AND H U M A N CHORlONlC GONADOTROPIN Mitsuko Kobayashi, Hiroko Hamada, Mareo Yamoto and Ryosuke Nakano From the Department of Obstetrics and Gynecology, Wakayama Medical College, Wakayama, Japan
Abstract A case of clear-cell carcinoma of the ovary in a 52-year-old woman having
an unusual menstrual history is presented. Serum concentrations of human chorionic gonadotropin (hCG) and estradiol were 120 mlU/ml and 86 pg/ml, respectively, while the serum FSH level was 43 mlU/ml. lmmunohistochemistry of the tumor revealed positive staining for both hCG and estradiol in the tumor cells.
CASE HISTORY A 52-year-old gravida 0, para 0 unmarried woman was referred for evaluation of abdominal distension of 2 months’ duration. Past history: menarche at the age of 14 years with regular 25-day menstrual intervals and 5 days of bleeding until she was 49 years old. After 2 years of amenorrhea, 25-30day intervals with 7 days of bleeding resumed. On the first visit, the abdomen was distended and a firm mass was noted in the lower part of abdomen. A Papanicolaou smear of the ascites was class IV. Concentrations of cancer antigen 125 (1400 U/ml) were elevated. Preoperative serum concentrations of FSH, LH, hCG and estradiol were 43 mIU/ml, 100 mIU/ml, 120 mIU/ml and 86 pg/ml, respectively. Normal levels of these hormones determined by radioimmunoassay in postmenopausal women are FSH (>40