Luteinized thecoma with sclerosing peritonitis presenting as an acute abdomen

The seventh reported case of luteinized thecoma with sclerosing peritonitis is described. Unlike the other reported patients with this condition, the patient presented with a short history of secondary amenorrhea, a subsequent acute abdomen, and an absence of abdominal distention and ascites. The tumor had undergone extensive hemorrhagic necrosis secondary to infarction, and the patient's amenorrhea may have been secondary to the release of steroid hormones from the necrotic cells. The presence of extensive necrosis and a brisk mitotic rate raised the suspicion of a malignant thecoma, but the finding of subserosal fibrosis in the biopsied omental tissue led to the diagnosis of a benign luteinized thecoma with sclerosing peritonitis.