Sangrado uterino del climaterio asociado a tumor funcionante de ovario. Reporte de dos casos

Dentro de las causas de sangrado uterino anormal se deben considerar los tumores funcionantes de ovario. A pesar de ser infrecuentes y generalmente de comportamiento benigno, su capacidad de producción estrogénica sostenida puede resultar en patologías benignas, premalignas o malignas del útero. Se reportan dos casos de sangrado uterino anormal en pacientes climatéricas, secundario a tecoma y fibrotecoma del ovario. Ambas pacientes fueron sometidas a cirugía con el diagnóstico preoperatorio de miomatosis uterina, y una de ellas tenía además hiperplasia endometrial. El hallazgo incidental de estos tumores de ovario al realizar la ooforectomía demuestra que pueden pasar desapercibidos si no se sospecha su existencia al abordar pacientes con sangrado uterino anormal. (AMC, 1997;39 (2):44-46)

Functional ovarian tumors must be considered as a possible etiology when we assess a patient with abnormal uterine bleeding. Although rare and usually exhibiting a benign clinical behavior, their ability to produce sustained high levels of estrogen can result in several uterine diseases, including premalignant and malignant conditions. We report two cases of abnormal uterine bleeding in climacteric women secondary to ovarian thecoma and fibrothecoma. Both patients had surgery performed under a preoperative diagnosis of uterine myomatosis, and one of them also had endometrial hyperplasia. The incidental diagnosis of the ovarian tumors by means of oophorectomy makes evident that they can easily be missed if they are not suspected when we approach patients with abnormal uterine bleeding.