Ovarian Sertoli–Leydig cell tumors: MRI findings and pathological correlation

Cai, Songqi; Zhao, Shufang; Qiang, Jin Wei; Zhang, Guofu; Wang, Xuezhen; Wang, Li

doi:10.1186/1757-2215-6-73

Cited by 20 publications

(11 citation statements)

References 17 publications

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“…These tumours usually affect young women and signs of androgen activity can be seen in about one-third of patients. Sertoli-Leydig cell tumours usually appear as solid masses; however, they may also present as heterogeneous lobulated lesions with both cystic and solid components [ 41 , 47 ]. On T2-weighted images, most of these tumours show a predominantly low signal intensity of the solid components, relating to the fibrous stroma, with some scattered cystic areas of high signal intensity (Fig.…”

Section: Imaging Findingsmentioning

confidence: 99%

MR imaging of ovarian masses: classification and differential diagnosis

et al. 2015

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ObjectiveWe propose a Magnetic Resonance Imaging (MRI) guided approach to differential diagnosis of ovarian tumours based on morphological appearance.BackgroundCharacterization of ovarian lesions is of great importance in order to plan adequate therapeutic procedures, and may influence patient’s management. Optimal assessment of adnexal masses requires a multidisciplinary approach, based on physical examination, laboratory tests and imaging techniques. Primary ovarian tumours can be classified into three main categories according to tumour origin: epithelial, germ cell and sex cord-stromal tumours. Ovarian neoplasms may be benign, borderline or malignant. Using an imaging-guided approach based on morphological appearance, we classified adnexal masses into four main groups: unilocular cyst, multilocular cyst, cystic and solid, predominantly solid. We describe MR signal intensity features and enhancement behaviour of ovarian lesions using pathologically proven examples from our institution.ConclusionMRI is an essential problem-solving tool to determine the site of origin of a pelvic mass, to characterize an adnexal mass, and to detect local invasion. The main advantages of MRI are the high contrast resolution and lack of ionizing radiation exposure. Although different pathological conditions may show similar radiologic manifestations, radiologists should be aware of MRI features of ovarian lesions that may orientate differential diagnosis.Teaching Points• Diagnostic imaging plays a crucial role in detection, characterization and staging of adnexal masses.• Characterization of an ovarian lesion may influence patient’s management.• Different pathological conditions may have similar radiologic manifestations.• Non-neoplastic lesions should always be taken into consideration.

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Section: Imaging Findingsmentioning

confidence: 99%

MR imaging of ovarian masses: classification and differential diagnosis

et al. 2015

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“…It occurs more often in young females between 20 and 30 years of age with an average age of 25 years and occasionally in children and menopausal women. SLCT was even reported in a 12-month-old infant [10], and the younger the patients, the lower the differentiation degree [1,2] . SLCT typically occurs unilaterally, mostly con ned to the ovary and seldom form distant metastases (2.5%) to other organsc [11,12,7,1] .…”

Section: Discussionmentioning

confidence: 99%

Successful pregnancy in an ovarian Sertoli-Leydig cell tumor patient with heterologous elements: case report and literature review

Han

Hao

Guo

et al. 2021

Preprint

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Background: Ovarian Sertoli-Leydig cell tumor (SLCT) is an extremely rare sex–cord stromal tumor of the ovary. Notably, ovarian SLCT with mucinous epithelium and liposarcoma is even rarer.There is also evidence that the presence of heterologous elements is a poor prognostic factor of SLCTs. Very often, ovarian SLCT patient first presents with high androgen levels and sometimes a clarge mass in the pelvic cavity, making it difficult for early diagnosis. Case presentation: In this study, we reported a SLCT patient with heterologous elements and elevated the serum alpha-fetoprotein (AFP) levels. A 22-year old nulliparous female was first admitted with clinical symptoms of abdominal pain, a large mass in the pelvic cavity and elevated serum AFP levels, and for this she underwent left adnexectomy. Pathological examination revealed ovarian SLCT with intestinal type mucinous epithelium and liposarcoma, and immunohistochemical staining revealed positive staining for AFP in the intestinal type mucinous epithelium. The patient became pregnant naturally four years later, but SLCT was found in the opposite ovary with liposarcoma but no significant increase in serum AFP levels.Further, we reviewed the literature in order to improve preoperative diagnosis and evaluation of long-term prognosis of SLCTs with heterologous elements.Conclusion: The increase in serum AFP levels could be used for preoperative diagnosis of the presence of heterologous elements and the postoperative recurrence.

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“…Atram [ 19 ] reported that the edematous stromal change is a constant feature of sclerosing stromal tumors of the ovary. Sertoli-leydig tumors were the subtype of malignant SCSTs which were enhanced intensely [ 2 , 3 , 20 ]. The mean ADC value of sertoli-leydig tumors was 1.009 × 10 − 3 mm 2 /s.…”

Section: Discussionmentioning

confidence: 99%

The value of MRI for differentiating benign from malignant sex cord-stromal tumors of the ovary: emphasis on diffusion-weighted MR imaging

Zhao

Qiang

et al. 2018

J Ovarian Res

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BackgroundTo investigate MRI for differentiating benign from malignant sex cord-stromal tumors of the ovary (SCSTs) emphasizing on the value of diffusion-weighted (DW) magnetic resonance (MR) imaging.MethodsThis retrospective study included 29 benign SCSTs in 28 patients and 13 malignant SCSTs in 13 patients. DW imaging as well as conventional MR imaging was performed. Signal intensity on DW imaging was assessed and apparent diffusion coefficient (ADC) value was measured. In addition, T2 signal intensity and contrast enhancement pattern were also assessed and compared between benign and malignant SCSTs.ResultsBoth of the T2 hypointensity and mild enhancement were specific to benign SCSTs. The majority of malignant SCSTs showed high signal intensity on DW imaging, whereas most benign SCSTs showed low or moderate signal intensity (p = 0.000). Fibromas were the tumors with the lowest observed ADC value (0.470 × 10− 3 mm2/s). Sclerosing stromal tumors were the tumors with the highest observed ADC value (2.291 × 10− 3 mm2/s). ADC value of solid component was significantly lower in malignant SCSTs (0.825 ± 0.129 × 10− 3 mm2/s) than in benign SCSTs (1.343 ± 0.528 × 10− 3 mm2/s) when fibromas were excluded (p = 0.024). T2, DCE and DW imaging has a limited value on the differential diagnosis of the benign and malignant SCSTs with an accuracy of 69.0%,71.4% and 78.1% respectively. Combination of T2, DCE and DW imaging permitted the distinction with an accuracy of 88.0%.ConclusionsIt is more helpful for distinction of the benign and malignant SCSTs by combining of T2, DCE and DW imaging than using each of the three sequences independently.

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Ovarian Sertoli–Leydig cell tumors: MRI findings and pathological correlation

Cited by 20 publications

References 17 publications

MR imaging of ovarian masses: classification and differential diagnosis

MR imaging of ovarian masses: classification and differential diagnosis

Successful pregnancy in an ovarian Sertoli-Leydig cell tumor patient with heterologous elements: case report and literature review

The value of MRI for differentiating benign from malignant sex cord-stromal tumors of the ovary: emphasis on diffusion-weighted MR imaging

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