Aaron E. Kanter

Theca cell tumors of the ovary

Abstract Certain ovarian tumors exert hormonal effects, and of the feminizing type there are two, the granulosa cell tumors and the theca cell tumors. Theca cell tumors have only recently been recognized. Two such cases are reported. They produced hyperplasia of the myometrium and endometrium, and postclimacteric bleeding. In one case the bleeding was periodic, resembling the normal menstrual cycle. The tumors are composed of cells which have the histologic characteristics of theca interna cells. Apparently these tumors secreted theelin. This conclusion is supported by much experimental and deductive evidence from the literature that the theca cells secrete the estrogenic hormone. Unfortunately, the tumors were formalin fixed before implantation experiments could be made, and no blood or urine tests for hormone were made, but perhaps future investigators may be able to do this, for diagnosis as well as for investigation. In this connection we reiterate an admonition made in a previous communication, 37 namely, if in a woman past the menopause who is bleeding, nothing of an etiologic nature is found in the systemic or local examination, and curettage proves barren, one should perform a colpotomy and visualize the ovaries, in order that guilty ovarian tumors be not overlooked.

Arrhenoblastoma of the ovary

Abstract A case of an arrhenoblastoma of the ovary is reported. It is characterized clinically by symptoms of defeminization as characterized by atrophy of the breast and fat of the gluteal region and symptoms of masculinization as characterized by hirsutism and hypertrophied clitoris. From a pathologic point of view, the diagnosis of arrhenoblastoma of the ovary is greatly enhanced by the use of the fluorescence microscope which enables one to demonstrate more definitely those cells which resemble the interstitial cells of Leydig as seen in a testicle.

A study of fibromyomas of the uterus with respect to the endometrium, myometrium, symptoms, and associated pathology

Abstract A study of the uterine walls, ovaries, and endometria in a series of 100 patients having fibromyomas with a correlation between these findings and the clinical histories and symptoms, still gives us no definite basis upon which to make an absolute statement as to a single etiologic or stimulating factor in the production of fibromyomata uteri, adenomyosis externa or interna, and hyperplasia of the endometrium with resultant menorrhagia, dysmenorrhea, or sterility. Evidence in favor of Witherspoons theory making hyperestrinism the single activator in the production of these pathologic and clinical entities, can be found in the observation of the rapid growth of fibromyomas during pregnancy and their puerperal and menopausal regression. Such facts follow very closely the estrin levels now well established, as does the discovery of hyperplasia of the endometrium associated with the presence of theca and granulosa cell tumors of the ovary in women who have passed the menopause. We have presented in our discussion factors that may tend to oppose this theory, at least in part. We must, therefore, feel with Witherspoon that hyperestrinism plays a part in the production of the changes herein studied and discussed, but we cannot be convinced that it is the sole agent because of the lack of consistency in the finding of other pathologic and symptomatologic entities in association with fibromyomas. The logical conclusion that can be derived from this study is that fibromyomata uteri, endometriosis, adenomyosis uteri, and hyperplasia of the endometrium with associated menorrhagia, dysmenorrhea, and sterility cannot be traced to a single etiologic agent but appear to be products of various and varying factors.

On the origin of the substance in urine which produces elongation of the bitterling ovipositor

Abstract The following experimental observations are reported: 1. When various fresh tissues were extracted with ether, only the adrenal extracts consistently caused the bitterling ovipositor to lengthen. Several species were investigated and the adrenals were positive in each instance. 2. The only other tissue which caused a positive reaction was the testis, positive in 5 of 12 cases. However, the quantity of fresh tissue necessary was several times greater than with the adrenals from the same case. 3. Crystalline compounds isolated from the adrenal were comparatively more effective than androsterone. 4. In 5 cases of Addisons disease a decrease was observed in the excretion of the ovipositor lengthening substance. 5. No decrease was observed in the urine of a castrated male. 6. Extracts from the adrenal causing the fish reaction had no influence on the capon comb in doses 40 to 200 times greater. The evidence indicates that the adrenal must be considered as one possible source of the factor in urine which causes the bitterling ovipositor to lengthen.