Ovarian Sertoli-Leydig cell tumors with heterologous elements I. Gastrointestinal epithelium and carcinoid: A clinicopathologic analysis of thirty-six cases

Young, Robert H.; Prat, Jaime; Scully, Robert E.

doi:10.1002/1097-0142(19821201)50:11<2448::aid-cncr2820501133>3.0.co;2-t

Cited by 139 publications

(53 citation statements)

References 12 publications

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“…27 On microscopic examination, the heterologous elements are of two basic types, endodermal elements characterized by gastrointestinal-type epithelium ( Figure 24) and mesenchymal elements, immature skeletal muscle or cartilage. 27,28 The presence of these tissues complicates the already wide range of appearances of Sex cord-stromal tumors of the ovary and testis RH Young SLCTs. The amount of mucinous epithelium in the tumors, which are usually of intermediate differentiation, varies from one or a few microscopic foci to numerous glands and cysts.…”

Section: Heterologous 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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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: Heterologous 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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“…Heterologous elements are various, such as carcinoid, mesenchymal, and mucinous epithelial tissues with the commonest being gastrointestinal-types [13,14]. Retiform pattern presents in 15% of SLCT, and is found only in intermediately and poorly differentiated SLCT, and often occurs in younger women [2,15,16].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2013

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BackgroundTo investigate the magnetic resonance imaging (MRI) characteristics of ovarian Sertoli-Leydig cell tumors (SLCT).MethodsThe clinical, MRI and pathological findings of five cases of SLCT were reviewed retrospectively. MRI appearances of tumors including laterality, shape and size, architecture, wall, septa and vegetation, signal intensity and contrast-enhancement pattern were evaluated and correlated with pathological findings.ResultsTwo tumors were solid which appeared as low signal intensity on T1-weighted imaging (T1WI) and moderate on T2-weighted imaging (T2WI) with multiple small cysts in one of them. The remaining three SLCT were multilocular cystic with the irregularly thickened wall and septa, and with solid area and mural nodules in one of them. The cystic components had the same signal intensity as urine. All the solid components were intensely enhanced after administration of contrast medium. All five tumors were pathologically intermediate differentiation and at FIGO stage I.ConclusionsSLCT demonstrate variable MRI morphological appearances. However, the irregularly thickened wall and septa, the moderate T2WI signal intensity and obvious enhancement in the solid components are three MRI features.

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“…For completeness, we will briefly note that signet ring cells may also be seen in the mucinous carcinoid component of Sertoli-Leydig cell tumors with heterologous elements. 33 Signet ring cells are occasionally found in primary ovarian carcinomas of other morphologic types. Che and colleagues 3 reported a series of poorly differentiated carcinomas mainly of serous, endometrioid, or mixed type with a microcystic pattern and signet ring cells containing intracytoplasmic mucin.…”

Section: Mccluggage and Youngmentioning

confidence: 99%

Primary Ovarian Mucinous Tumors With Signet Ring Cells

McCluggage¹,

Young²

2008

American Journal of Surgical Pathology

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The distinction between a primary ovarian mucinous carcinoma or even a borderline mucinous tumor and a metastatic mucinous carcinoma may be difficult. A constellation of clinical, gross pathologic and morphologic features is used in this distinction. One of the most important morphologic features suggesting a metastatic mucinous carcinoma in the ovary is the presence of signet ring cells; these are considered rare in primary ovarian mucinous tumors. In this study, we report 3 primary ovarian mucinous tumors with a component of signet ring cells. The tumors arose in patients aged 27, 55, and 60, were unilateral, confined to the ovary and stage IA. They ranged from 9 to 27 cm; 1 was grossly a multiloculated cystic lesion and 2 were cystic and solid. In one case, the neoplasm had the architecture of a mucinous adenofibroma but had frankly malignant cells lining glands and forming solid aggregates of cells. A second tumor also had the background of an adenofibroma. The third was mostly a mucinous cystadenoma. In one case, endometriosis was present in the same ovary; teratomatous elements were not identified in any case. Immunohistochemistry, performed in 2 cases, showed both to be diffusely positive with CK7 and CA19.9, including the signet ring cells. CK20 was positive in both cases (1 focal; 1 diffuse). Estrogen receptor and CA125 were diffusely positive and carcinoembryonic antigen and CDX2 focally positive in 1 case. Chromogranin and synaptophysin were negative. Investigations to exclude a gastrointestinal neoplasm in 2 cases were negative. Features favoring a primary rather than a metastatic neoplasm are unilateral tumor, low stage, background of adenofibroma or cystadenoma, associated endometriosis in 1 case and an absence of features which are characteristic of secondary mucinous carcinomas in the ovary, such as surface tumor deposits, a nodular growth pattern, and lymphovascular permeation. Immunohistochemistry is of limited value because of overlapping immunophenotype between a primary ovarian mucinous tumor and a metastasis from the stomach, pancreas, biliary tree, appendix, or colorectum, the most likely primary sites for a secondary exhibiting similar features. Our study illustrates that signet ring cells occur rarely in a primary ovarian mucinous tumor; even when conspicuous the features differ from those of the usual Krukenberg tumor. At least some cases of so-called primary Krukenberg tumor may be similar to our cases. However, the designation primary Krukenberg tumor should not be used as, apart from the signet ring cells, a resemblance to a "true" Krukenberg tumor of the secondary type is limited. The tumors should be classified according to the underlying background neoplasm with a notation concerning the signet ring cell component.

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Ovarian Sertoli-Leydig cell tumors with heterologous elements I. Gastrointestinal epithelium and carcinoid: A clinicopathologic analysis of thirty-six cases

Cited by 139 publications

References 12 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

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

Primary Ovarian Mucinous Tumors With Signet Ring Cells

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