An Intriguing Case of Virilising Sertoli-Leydig Cell Tumour of the Ovary
Abstract
Sertoli-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.References
Charles J. Zaloudek C J, Garg K. Tumors of the Female Genital Tract. In, Christopher D.M. Fletcher (ed). Diagnostic histopathology of tumors, 4th edition. China, Saunders, 2013; 658-870.
Young RH, Scully RE. Ovarian Sertoli-Leydig cell tumours.A clinicopathological analysis of 207 cases. Am J Surg Pathol.1985;9:543–569. [PubMed]
Roth LM. Sex cord stromal tumor of the ovary. Young RH, Scully RE. Steroid cell tumor of the ovary. In: Fox H, Wells M, editors. Obstetrical and Gynecological pathology. 5nd ed. United Kingdom; 2003; 745-765, 845-849.
Faria AM, Perez RV, Marcondes JA, Freire DS, Blasbalg R, Soares J, et al. A premenopausal woman with virilization secondary to an ovarian Leydig cell tumor. Nat Rev Endocrinol. 2011 Apr; 7(4):240-5. Epub 2011 Feb 15.
Tandon, R., Goel, P., Saha, P. K., Takkar, N., & Punia, R. (2007). A Rare Ovarian Tumor – Sertoli-Leydig Cell Tumor With Heterologous Element. Medscape General Medicine, 9(4), 44.
Roth LM, Liban E, Czernobils B. Ovarian endometrioid tumors mimicking sertoli and sertoli-leydig cell tumors. Sertoliform variant of endometrioid carcinoma. Cancer ;1982: 1322–1331
Weng C.S., Chen M.Y., Wang T.Y., Tsai H.W., Hung Y.C., Yu K.J., Chiang Y.C., Lin H., Lu C.H., Chou H.H. Sertoli–Leydig cell tumors of the ovary: a Taiwanese gynecologic oncology group study. Taiwan. J. Obstet. Gynecol. 2013; 52:66–70. [PubMed] [Ref list]
Chen L., Tunnell CD, De Petris G. Sertoli–Leydig cell tumor with heterologous element: a case report and a review of the literature. Int. J Clin Exp. Pathol. 2014;7:1176–1181. [PubMed] [Ref list]
Colombo N, Parma G. Ovarian sex cord stromal tumors. In: Gershenson DM, Mcguire Mc, Gore M, Quinn M A, Thomas G, editors. Gynecologic Cancer. 2nd ed. Elsevier; 2005; 503-7
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