TITLE:
Ovarian Thecoma Fibroma Causing Menstrual Disorder & Infertility: Dramatic Resolution with Surgery
AUTHORS:
F. C. J. Emegoakor, P. C. Udealor, E. P. Ezenkwele, M. Nzegwu
KEYWORDS:
Thecoma-Fibroma, Oligo-Amenorrhoea, Infertility, Premenopausal
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.6,
June
22,
2020
ABSTRACT: Purpose: To report the case of successfully managed oligo-amenorrhoea with
infertility as a result of thecoma fibroma in a young
Nigerian Igbo woman. Case Presentation: She was a 24-year-old, married, nulliparous woman who presented with 5 years history of oligomenorrhoea and 18 months history of infertility. Following her menarche at 14 years of
age, she had a regular 30-day menstrual cycle with 4 - 6 days
moderate flow. Symptoms of oligomenorrhoea worsened to amenorrhoea over time
with menstrual flow occurring only when a progesterone agent was used. Clinical
evaluation revealed no abnormalities in the systems apart from the presence of
left adnexal mass on pelvic examination. Radiological test suggested benign
left adnexal mass. Results: She had surgical removal of the mass after
work up. Her normal menstrual flow resumed 48 hours following surgery and
became regular thereafter. The histopathology report confirmed thecoma-fibroma.
She commenced sexual intercourse 12 weeks after surgery. At 18 weeks post
operative period, she presented with amenorrhoea and pregnancy symptoms. Intra-uterine
pregnancy was confirmed with a pelvic ultrasound scan. She was managed in
antenatal clinic till 38 weeks gestational age when she had spontaneous vaginal
delivery of a live female neonate that weighed 3 kg with
good APGAR scores. She is currently being followed up. Conclusion: Ovarian thecoma-fibroma is a rare cause of menstrual irregularities and infertility in
young women. Surgical removal could result in a dramatic and favourable
clinical response, as in the case presented.