Stromal ovarian tecomatosis

In 1942, S. Geist and J. Geines were the first to publish the unusual results of a histological examination of ovarian tissue in patients with Stein-Leventhal syndrome. They found foci of "luteinized" tecal cells, similar to theca interna folliculi cells, scattered along the ovarian "stroma" outside the follicles. The following year, L. Fraenkel in his work called these histopathological changes in ovarian hypertosis. In 1949, A. Culiner and S. Shipel used the term "hypertension syndrome" to refer to conditions in which foci of "tekomatosis", consisting of 10-30-60 individual hypertrophic and luteinized tecal cells in the ovarian "stroma", combined with the clinical picture of defemini ation and virilization. In subsequent years, due to the lack of a unified terminology in the literature, synonyms such as hypertosis, cortical stromal hyperplasia, stromal proliferation, stromal tecosis, and tecomatosis were used. R. Feinberg proposed dividing hypertosis into 3 groups, based on the predominance of cystic follicles and a thickened white membrane (mixed tecosis) with increased proliferation of the actual cells of the interstitial tissue or without it (internal tecosis). The presence of "stromal" proliferation in the absence of phenomena of cystic atresia of the follicles, he defined the term "stromal tecosis" (tekomatosis). I.V. Golubeva for the first time in our country drew attention to the clinical and hormonal features of stromal tecomatosis (ST), which was previously considered in the framework of polycystic ovary syndrome, and after 3 years M.E. Bronstein proved that this is an independent morphological form and gave a definition concepts of ST. Ovarian CT is understood as hyperplasia of the interstitial tissue of the ovaries and the appearance in it of groups of hypertrophied epithelioid cells that form foci of various sizes without any connection with follicles. The subject of this review is the consideration of the clinical and morphological picture of this disease, the features of hormonal homeostasis, modern hypotheses of the pathogenetic mechanisms of its development, as well as possible treatment options.