Moderately differentiated Sertoli-Leydig cell tumor of ovary with associated mucinous carcinoma and carcinoid—A case report and review of literature

Abstract

Sertoli-Leydig Cell Tumors (SLCT) are very rare neoplasms of the ovary (0.2%) and they belong to the group of sex cord-stromal tumors. Of these, 20% of the cases show heterologous elements. We report a case of a 22-year-old woman who presented with complaints of lower abdominal pain and secondary amenorrhea for 10 months. Physical examination revealed right lower abdominal tenderness and fullness. Imaging showed a right ovarian mass. She underwent right salpingo-oophorectomy with bilateral pelvic lymphadenectomy and omentectomy. Microscopic examination revealed a neoplasm with varied histomorphological patterns. The predominant pattern was an atypical proliferative mucinous tumor with foci of microinvasion. The other component was that of moderately differentiated Sertoli-Leydig Cell Tumor. Focal areas resembling carcinoid were also noted. Immunohistochemistry was performed and the Sertoli-Leydig Cells were positive for CD56, calretinin, inhibin, vimentin, and ER. The glandular component was positive for CK20, EMA, CEA, and CDX2. Synaptophysin and chromogranin were positive within nests resembling carcinoid. With the given histomorphological features and immunohistochemistry findings, a diagnosis of moderately differentiated Sertoli-Leydig Cell Tumor of the ovary with associated mucinous carcinoma and carcinoid was rendered. The presence of heterologous elements in SLCTs has been reported to be associated with poor prognosis.

Ultrasound examination assisted clinical diagnosis of Leydig cell tumor of ovary: An extremely rare case report

“…Approximately 90% of patients can be detected in the early stages of the disease, with less than 3% presenting with extra-ovarian dissemination and a small number of patients with other combined ovarian lesions. [ 11 , 12 ] Most patients have the opportunity to choose a surgical option that preserves reproductive function after early diagnosis, and testosterone levels generally decrease rapidly to normal after tumor removal and patients are able to regain their femininity quickly. [ 5 ]…”

“…Approximately 90% of patients can be detected in the early stages of the disease, with less than 3% presenting with extra-ovarian dissemination and a small number of patients with other combined ovarian lesions. [11,12] Most patients have the opportunity to choose a surgical option that preserves reproductive function after early diagnosis, and testosterone levels generally decrease rapidly to normal after tumor removal and patients are able to regain their femininity quickly. [5] Imaging ancillary examinations are very important in diagnosis, and ultrasonography is a noninvasive, convenient, efficient, and mature examination modality that has become the preferred method for adnexal tumor diagnosis because of its high sensitivity, good acceptability, and low cost.…”