Androblastoma of the Ovary: Clinical, Diagnostic and Histopathologic Features

Abstract

Androblastomas of Sertoli-Leydig cell tumors of the ovaries are classified into the group of sex cord stromal tumors and represent an extremely rare form of tumor (0.2% of all ovarian tumors) in women. Their malignant potential is lower than that of epithelial ovarian cancer. They cause signs of virilization, although these are not obligatory. In many cases secondary amenorrhea is the only symptom of the disease. This leads to an intensive search for the source of the disorder. Frequently only the elevated production of androgens gives a preoperative clue to the tumor type. The recommendation to include the measurement of androgen levels in the routine diagnosis of secondary amenorrhea must therefore be endorsed. The tumors are usually sonographically identifiable; in differential diagnosis, hyperandrogenemia of other origins (e.g., Cushing’s disease, adrenal hyperplasia, pituitary adenoma, other causes of ovarian and adrenal androgen hypersecretion, intersexuality, medically induced androgenization) have to be ruled out. In view of the good prognosis, the therapy of choice consists simply in adnexectomy of the affected side. With regular measurement of serum androgen levels an effective control of the course of the disorder is possible. A conclusive pathological diagnosis is difficult as heterologous tumors and mixed tumors exist and, furthermore, other tumor types are capable of imitating Sertoli-Leydig cell tumors.

Sertoli‐Leydig cell tumor ‐ a rare androgen secreting ovarian tumor in postmenopausal women: case report and review of literature

“…The virilizing effects of the tumor were most probably caused by accumulation of testosterone due to deficiency in enzymes transforming testosterone to 17-ketosteroids or aromatization to estrogens [2]. SLCT requires a differential diagnosis with other origins of hyperandrogenemia (drugs induced androgenization, Cushing's syndrome, neoplasms of the adrenal, other neoplasms of the ovary, pituitary adenoma, adrenal hyperplasia, polycystic ovary syndrome, several systemic conditions) [3].…”

Menopausal Androgen Excess - Associated Cardio-Metabolic Risk: Clues for Ovarian Leydig Cell Tumour (Case Report and Mini-Review of Literature)

“…Usually for the evaluation of androgen excess or virilization syndrome, the patient addresses to an endocrinologist, gynecologist or dermatologist. If androgen excess is extreme and prolonged, androgenic features are accompanied with virilization of the genitals and so, gynecological examination is essential to evaluate the presence of changes in the external genitalia like clitoromegaly or adnexal masses (22,23). In our patient gynaecological examination revealed normal external genitalia and a firm right adnexal mass.…”

Fertility-sparing management and obstetric outcomes in a 20-year-old patient with a Sertoli-Leydig cell tumor of the ovary: A case report and review of the literature

“…When handling cases of patients exhibiting secondary amenorrhea with or without virilization, serum androgen levels should be measured during diagnostic procedures, as in certain cases, elevated serum androgen levels may be the only pre-operative indication of an SLCT. A differential diagnosis for alternative causes of hyperandrogenemia (Cushing's syndrome, pituitary tumors or medicine causing androgen hypersecretion) should be performed (14). In addition, less frequently observed estrogenic manifestations (for example, hemorrhage) may be present, particularly in postmenopausal women, and diagnostic curettage typically reveals an irregular proliferative endometrium, hyperplasia or endometrial carcinoma (3).…”