Arrhenoblastoma: A Malignant Ovarian Tumor Associated with Endocrinological Effects

Abstract

Only since the year 1930, chiefly through the writings of Robert Meyer and Emil Novak, has our attention been called to the observation that certain of the malignant ovarian neoplasms appear to produce hormones which may be biologically active and clinically important. Since that time a few more examples have been reported; but, probably because one observer sees so few of these cases, our ideas unfortunately have not become very well defined. At the outset it needs to be emphasized that any significant investigation of the ovarian tumors belonging to this group demands that the problem be approached from many widely differing points of view. Questions of genetics, ontogeny, embryology, sex determination, sex differentiation, intersexuality, oncology, histologic pathology, endocrinology, clinical medicine, and operative surgery are all, as a necessary consequence, inseparably joined in the consideration of each individual case. Many of these subjects are young in years and limited in their scientific scope; none has attained epistemological accuracy. It is not strange, therefore, that many hazy ideas should be encountered and caution is necessary because, owing to the inexactness of some of our fundamental concepts, many seemingly tenable premises may be found to be quite incorrect, and many attractive conclusions may fail of substantiation in the light of more complete knowledge. With this note of admonition well in mind, sound progress can be expected. At one time all tumors were thought of as autonomous growths; they were considered, by definition, to be functionless, semiparasitic lesions whose effects upon the host were always indirect. Within the quarter century just past this notion has been wholesomely modified. Today we recognize a definite group of neoplasms which are characterized by functional activity and by ability to affect profoundly the physiology of the body through the formation of hormones. These are particularly those benign adenomatous tumors which take origin from the endocrine glands. Among these are the acidophil adenomas of the hypophysis, the primary hyperplasias of the parathyroid, the cortical and chromaffin adenomas and the primary hyperplasias of the adrenal, and the islet tumors of the pancreas. In the case of these, every possible proof has been brought to demonstrate their secretory activity and to incriminate them in the production of profound physiological disturbances.