Table 1.

Summary of Cases of Elevated Inhibin B with Ovarian Thecomas. Prior cases of elevated inhibin B with ovarian thecomas have all been published in the reproductive endocrinology literature. Three cases were premenopausal women presenting with secondary amenorrhea and infertility. All cases, including the current case, had markedly elevated inhibin B levels with a normal estradiol level. Normal range for inhibin B is 10–200 pg/mL. Normal range for follicular phase estradiol level 69 to 905 pmoL/L.

	Author	Journal	Publication Year	Age	Initial presentation	Inhibin B level (pg/mL)	Estradiol (pmol/L)	Other serum hormone levels/Tumor markers	Procedure	Frozen section	Tumor Diameter (cm)	Immunohistochemistry Stains	Final pathology
1	Meyer et al.	Fertility and Sterility	Feb. 2000	37	Secondary amennorrhea and infertility	1154	114	FSH 1.7 mIU/mL; LH 23.4 mIU/mL; normal prolactin	Diagnostic laparoscopy, chromotubation, Right ovarian cystectomy, Left ovarian excresence biopsy	Right: steroid cell tumor, no carcinoma; Left: fibro-thecomatosis vs. stromal hyperplasia	5	Strongly positive anti-Inhibin A staining. LH staining negative. Numerous psammoma bodies.	Fibrothecoma (R.) and stromal hyperplasia (L.)
2	Donovan et al.	Fertility and Sterility	Aug. 2010	20	Secondary amennorrhea and infertility	552	31	FSH 1.6 IU/L, LH 44.6 IU/L, prolactin 6 ug/L	Exploratory laparotomy, right oophorectomy	N/A	5.4	Pale elongated cells positive for inhibin alpha separated by hyalinized stroma	Thecoma
3	Van Liempt et al.	Human Reproduction	Apr. 2012	39	Secondary amenorrhea and hot flashes	553	75	CA-125 41 U/mL; CEA < 5ug/L; CA19-9 23 U/mL; BhCG < 5 U/L; AFP < 5 ug/L; Inhibin A 44 ng/L; FSH 1.9 U/L; LH 22 U/L, prolactin 0.15 U/L, Testosterone < 1.0 nmol/L, AMH 3.9 U/L	Staging laparotomy including bilateral salpingo-oophorectomy	N/A	10	Tumor positive for inhibin and negative for estrogen receptor markers. Adjacent papillary structures with seromucinous components staining negative for inhibin.	Fibrothecoma (R.), bilateral borderline seromucinous tumor
4	Hugon-Rodin et al.	Gynecologic Endocrinology	Nov. 2016	60	Referral for low FSH postmenopause in rheum work up for arthralgia	475	40	CA-125 7.8 U/mL; CEA 0.9 ug/L; HCG 4.0 UI/L, AFP < 2 ug/L; Inhibin A 100 pg/mL; FSH 6 IU/L; LH 33 IU/L; AMH < 0.3 pmol/L; Testosterone 0.33 nmol/L	total abdominal hysterectomy, bilateral salpingo-oophorectomy	N/A	11	Strongly positive anti-Inhibin A staining. Abundant collagenized bundles.	Fibrothecoma
5	Current		Oct. 2020	59	Recurrent postmenopausal bleeding	1915	63.5	CA-125 10.9 U/mL, Inhibin A 5.7, total estrogens 50.3 pg/mL, Estrone 33.0 pg/mL, Testosterone 24 ng/dL	total laparoscopic hysterectomy, bilateral salpingo-oophrectomy with removal of left adnexal mass, omental biopsy, and peritoneal washings	Favor sex cord stromal tumor with extensive luteinization	5	Special stain with reticulin is positive. Immunostains for inhibin, calretinin and smooth muscle actin are positive. Stains for desmin, beta-catenin and CD10 are negative	Ovarian thecoma, serosal endometriosis of uterus