Ovarian hyperthecosis associated with pseudosarcomatous changes in the endometrial stroma

This report documents a case of ovarian hyperthecosis associated with endometrial adenocarcinoma and pseudosarcomatous changes within the endometrial stroma. Previous descriptions of endometrial pseudosarcoma have emphasized its association with a history of exogenous progestogen administration; however, since this patient was not taking any medication, the source of the progestogen effect in the present case is presumed to be the hyperplastic ovarian cortex. Progestogen effects on target organs associated with ovarian hyperthecosis have not been described. However, the ovarian cortex does have progestogen forming potential, and pseudodecidual transformation of ovarian cortex seen in the present case and in other cases of ovarian hyperthecosis is presumptive evidence of progestogen formation.