An Intriguing Case of Virilising Sertoli-Leydig Cell Tumour of the Ovary
AbstractSertoli-Leydig cell tumours (SLCTs) are rare sex cord stromal neoplasms of the ovary. They are more commonly seen in the reproductive age group and are rare in the postmenopausal period. The average age of presentation is 30yrs. We report a rare case of Leydig cell tumour with an interesting presentation in a postmenopausal woman. A 60-year-old woman, postmenopausal for 12 years, presented with hirsutism, male pattern baldness and deepening voice over the past five years. On general examination, she had hirsutism, male pattern baldness with hoarseness of voice. Her blood counts and metabolic profile was normal. However, endocrinology work-up showed increased levels of testosterone (980ng/dl) (N 15-70 ng/ml). MRI Abdomen and Pelvis revealed a left adnexal mass measuring 4.1x4.0x3.3 cm which was heterogeneous with a centrally hyper intense area. No invasion in the surrounding structures was seen. No ascites was present. Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy was done. Histological examination and immunohistochemical findings were of Sertoli-Leydig cell tumour. Postoperatively the symptoms of the patient abated and the levels of testosterone came back to normal.
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