Thecoma are benign neoplasm that occurs in a woman’s ovaries. They are also known as theca cell tumors since they are made of theca cells.
Theca cells are cells that control the production of androgen. These tumors are estrogen-producing tumors. While thecoma can occur at any age they are most common in women over the age of 59 who have already gone through menopause.
Thecoma vary in size, but on average they are seven to eight centimeters in diameter. They are often yellow or orange in color and sometimes contain a liquid cytoplasm.
Approximately 90% of thecoma are unilateral, meaning they only occur on one side in one ovary. Overall thecoma are rare. They make up about 1% of all ovarian tumors. Thecoma have been associated with abnormal uterine bleeding and endometrial carcinoma.
Abnormal uterine bleeding is seen in approximately 60% of cases and endometrial carcinoma is seen in about 20% of cases.
Signs and Symptoms
Signs and symptoms of thecoma vary by the age of the patient, but the most common ones are menstrual irregularities and bleeding after menopause. Menstrual irregularities include oligomenorrhea and menorrhagia.
Oligomenorrhea is when there are fewer and lighter periods than normal with 35 or more days between them. Menorrhagia is the opposite condition. This results in heavy periods at irregular intervals. Depending on the cause menorrhagia can also result in painful periods.
Patients often also experience pain and discomfort in their abdomen. They can feel as if they have gained weight. Since thecoma is estrogen-producing patients sometimes see side effects like enlarged breasts, breast tenderness and increased vaginal secretions.
Younger girls who have not yet gone through puberty can begin to experience signs of precocious pseudo puberty as a result of a thecoma.
Thecoma are diagnosed mainly when a woman experiences abnormal uterine bleeding. Doctors will perform many tests including a physical exam and blood tests. They will do image testing to see where the tumor is and how large it is. In the case of thecoma sonograms have shown to be most useful. Thecoma are staged based on how far along the tumor is and whether or not it has spread to other parts of the body.
Treatment for thecoma is usually surgery. Since thecoma are benign once the tumor is removed and the estrogen that it was producing has been stopped, the patient’s symptoms go away. Surgery can involve a complete hysterectomy that removes the ovaries and the uterus. Alternatively, a patient may only need to have her ovaries, or her ovaries and fallopian tubes, removed.
With early detection and treatment the prognosis for thecoma is quite good.