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Thecoma is a rare stromal tumor of the ovarian sex cord that affects only about 1% of all ovarian cancers. It is usually benign and produces estrogen or androgens, but can occasionally be malignant. Treatment options include surgery, which is usually curative.
A thecoma, also known as a theca cell tumor, is classified as a stromal tumor of the ovarian sex cord. This type of tumor is relatively rare. Thecomas affect only about 1% of all ovarian cancers.
The ovaries produce theca cells, endocrine cells that control the production of androgen hormones. Pure thecoma tumors are composed of theca cells. The tumors are usually yellowish or orange in color with a well-defined shape and a stiff, inflexible texture. They grow between 0.25 inch and 0.31 inch (7 cm to 8 cm) on average, but their size varies widely depending on the patient. Theca cell tumors often contain droplets of fat and a gelatinous liquid called cytoplasm.
Typical thecomas usually affect women around menopause, and women aged 50 to 60 are in the highest risk category. More than 90% of all thecomas are unilateral or affect only one side, but occasionally form on both ovaries. They are benign in most cases. Occasionally a thecoma tumor will prove to be malignant. Malignant tumors usually contain granulosae, which are a different type of ovarian cell, as well as theca cells.
Thecomas usually produce estrogen. Some women who develop thecomas experience symptoms such as irregular menstruation or postmenopausal spotting or bleeding due to excessive estrogen production. Other thecoma tumors produce androgens, which are male hormones produced in the female adrenal glands and ovaries. Younger women — those under 30 — are susceptible to luteinizing thecomas, which are a type of cancer that contains steroid cells. A rare type of thecoma, called a Sertoli-Leydig tumor, produces testosterone, so women with this type of thecoma can develop masculine characteristics such as a deeper voice and excess facial hair.
Treatment options include complete hysterectomy, which removes the uterus and ovaries; surgical ovariectomy or removal of the ovary; and salpingo-oophorectomy, or removal of the fallopian tube and ovary. These surgeries are usually curative, because they remove the hormone-producing tumor. Younger women who want to become pregnant at some point may opt for wedge resection surgery, which removes only some of the ovarian tissue to limit the amount of hormones produced. Doctors often recommend more radical surgeries for women who have granulosa cells mixed with thecoma tumors, because this type of tumor occasionally becomes malignant. Many of the symptoms of excessive hormones resolve within several months after surgery.
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