Stromal luteoma in a case of multiple leiomyomatosis – A rare case report

Abstract

Stromal luteoma of the ovary occurs mostly in postmenopausal females and is very rare. They account for 60% Abnormal vaginal bleeding is the most frequent presentation, but endocrine symptoms and sometimes virilizing signs may also be observed. This tumour is a close mimicker of Leydig cell tumour. However, the stromal location and the absence of Reinke’s crystalloids helps to confirm the diagnosis. This tumour is surrounded by an ovarian stroma, entirely composed of luteinized cells devoid of crystals of Reinke. We report an unusual case of a 41 year old female who presented with abdominal pain and menorrhagia. A TAH + BSO was performed and microscopy revealed a stromal luteoma of the right ovary with multiple intramural and subserosal fibroids. Preoperative diagnosis was a leiomyoma. However, microscopy revealed a stromal luteoma in the ovary. One third of the stromal luteomas are incidental findings. The preoperative and intraoperative diagnosis of this condition is challenging. Awareness about this condition among pathologists and clinicians may help in preventing misdiagnosis and overtreatment.