Granulosa cell, Sertoli-Leydig cell, and unclassified sex cord-stromal tumors associated with pregnancy: A clinicopathological analysis of thirty-six cases

Young, Robert H.; Dudley, Ainsworth G.; Scully, Robert E.

doi:10.1016/0090-8258(84)90026-x

Cited by 145 publications

(66 citation statements)

References 57 publications

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“…51 Placement in this group happens more frequently in males. In females, a disproportionate number of tumors from pregnant patients are placed in this group 26 and the peculiar neoplasm that Talerman et al 52 have categorized as 'diffuse nonlobular androblastoma' in our opinion probably is best placed in the unclassified group because it has hybrid features between the granulosa and Sertoli cell families. There is nothing unique about the general clinical profile of the unclassified sex cord-stromal tumors of the ovary and the prognosis of individual cases has to be evaluated using basic principles according to their features.…”

Section: Sex Cord-stromal Tumors Unclassifiedmentioning

confidence: 73%

“…26 The change that causes most difficulty is marked intercellular edema often resulting in large areas with a nonspecific, loose appearance ( Figure 23) that may be confused with the reticular pattern of a yolk sac tumor. Occasionally sheet-like aggregates of Leydig cells may obscure the Sertoli cell component and potentially lead to the misdiagnosis of a Leydig cell tumor.…”

Section: Ovarian Slctsmentioning

confidence: 99%

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Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems

2005

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Gonadal sex cord-stromal tumors contain some of the most morphologically interesting neoplasms of the gonads and these lead to many important issues in differential diagnosis. The pathology of these tumors is reviewed with emphasis on new information, similarities and differences in the two gonads, and diagnostic problems. Sertoli cell tumors occur in both gonads being more common in the testis where they usually exhibit a lobular pattern of hollow or solid tubules. In the ovary, tubular differentiation is usually the predominant feature but the lobulation typically seen in the testis is generally not as striking. One variant of Sertoli cell tumor, the large cell calcifying form, appears to be restricted to the male gonad and in contrast to other sex cord tumors is much more frequently bilateral and is associated in many cases with unusual clinical manifestations. In both sexes, patients with Peutz-Jeghers syndrome often have distinctive gonadal pathology. In females, it is in the form of the sex cord with annular tubules whereas in males, the lesion has features that are often intermediate between those of a sex cord tumor with annular tubules and a large cell calcifying Sertoli cell tumor. Sertoli-Leydig cell tumors are more morphologically diverse than pure Sertoli cell tumors and for practical purposes are an issue only in ovarian pathology being exceptionally rare in the testis. The classification proposed by Meyer into well, intermediate, and poor differentiation, remains important prognostically. More recently, heterologous and retiform differentiation has been described. Heterologous tumors most often contain mucinous epithelium, sometimes with small foci of carcinoid or less commonly, and generally in poorly differentiated neoplasms, rhabdomyosarcoma or fetal-type cartilage. Such tumors should be distinguished from pure sarcomas and teratomas. The retiform neoplasms, which tend to occur in young females, may mimic serous borderline tumors or even serous carcinomas. Granulosa cell tumors are much more common in females and in both gonads are divided into adult and juvenile forms. In females, granulosa cell tumors and other sex cord tumors may have markedly bizarre nuclei potentially leading to overdiagnosis as more malignant neoplasms. The juvenile granulosa cell tumor of the testis tends to occur in the first 6 months of life and should be carefully distinguished from the yolk sac tumor of the testis, which usually occurs in a slightly older age group. Occasional sex cord-stromal tumors cannot be readily categorized into the Sertoli or granulosa families and are diagnosed as sex cord-stromal tumors unclassified. In females, this is a relatively common placement for a neoplasm in a pregnant patient. Unclassified tumors are overall more common in males and may entrap residual normal germ cells potentially leading to the erroneous placement of the tumor in the category of a mixed germ cell sex cord-stromal tumor. From the practical viewpoint, the most helpful immunohistochemical findings are the negative s...

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Section: Sex Cord-stromal Tumors Unclassifiedmentioning

confidence: 73%

Section: Ovarian Slctsmentioning

confidence: 99%

Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems

2005

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“…They account for only 0.2% of malignant ovarian tumours and are often found unilaterally (1). Synonyms in the literature are arrhenoblastoma, androblastoma and gonadal stromal tumour of the android type.…”

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confidence: 99%

Use of novel serum markers in clinical follow-up of Sertoli-Leydig cell tumours

Lenhard

Kuemper²,

Ditsch³

et al. 2007

Clinical Chemical Laboratory Medicine

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Background: Sertoli-Leydig cell tumours of the ovary account for only 0.2% of malignant ovarian tumours. Two-thirds of all patients become apparent due to the tumour's hormone production. Methods: A 41-year-old patient (gravida 4, para 4) presented with dyspnoea, enlarged abdominal girth and melaena. Diagnostic imaging was suspicious for an ovarian cancer. The standard tumour marker for ovarian cancer (CA 125) was elevated to 984 U/mL. Results: Surgical exploration of the abdomen revealed a mouldering tumour of both adnexes extending to the level of the navel. Frozen sections showed an undifferentiated carcinoma of unknown origin. Radical surgery was performed. The final histological report described a malignant sex-cord stroma tumour, a Sertoli-Leydig cell tumour, emanating from both ovaries. Analysis of preoperative blood serum showed elevated levels of CYFRA 21-1 (10.4 ng/mL), neuron-specific enolase (36.2 ng/mL), oestradiol (485 pg/mL) and CA-125 (984 U/mL). Adjuvant chemotherapy and regional hyperthermia were performed due to the malignant potential and incomplete resection of the tumour. Conclusions: Undifferentiated Sertoli-Leydig cell tumours show a poor clinical course. As only twothirds of patients with this rare disease present with elevated hormone levels, new markers deserve further investigation to offer more specific, individualised tumour monitoring. Clin Chem Lab Med 2007;45:657-61.

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“…In one study, pregnant patients, with one exception, were initially treated by conservative surgical procedures. Hysterectomy and salpingo-oophorectomy were performed at a second operation; no residual tumor was found in any of the specimens [8]. In our case, the tumor size was approximately 14 cm, and the stage was IIIC.…”

Section: Discussionmentioning

confidence: 99%

“…Epithelial cancers and tumors with low malignant potential are the most common ovarian cancers found in pregnancy [5]. In a study of 36 cases of gonadal stromal tumors during pregnancy, there were only six cases of unclassified sex cord stromal tumors [8].…”

Section: Discussionmentioning

confidence: 99%

Unclassified tumor of the gonadal stroma in a pregnant woman

Tekcan¹,

Naki²,

COŞKUN³

et al. 2006

Gynecol Surg

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Gonadal sex cord stromal tumors contain some of the most morphologically interesting neoplasms of the gonads, and these lead to many important issues in differential diagnosis. Granulosa cell tumors are much more common in females. Unclassified sex cord stromal tumor is rare. We report a case of a 22-year-old woman with acute ruptured unclassified sex cord stromal tumor of the right ovary during pregnancy. The biological behavior of unclassified sex cord stromal tumors resembles that of Sertoli-Leydig cell tumors of intermediate differentiation rather than poorly differentiated tumors, which may have been expected in view of the lack of specific differentiation. This finding is important with regard to postoperative management.

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Granulosa cell, Sertoli-Leydig cell, and unclassified sex cord-stromal tumors associated with pregnancy: A clinicopathological analysis of thirty-six cases

Cited by 145 publications

References 57 publications

Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems

Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems

Use of novel serum markers in clinical follow-up of Sertoli-Leydig cell tumours

Unclassified tumor of the gonadal stroma in a pregnant woman

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