Sertoli-Leydig Cell Tumour of Ovary with Menorrhagia: A Rare Case Report

Abstract

A 28-year-old female, presented with pain in abdomen since 15 days and with a history of menorrhagia since two years. Per vaginal examination revealed a left adnexal mass. There were no clinical features suggesting virilisation. USG and CT scan of abdomen and pelvis revealed a left sided large ovarian neoplasm. On laparotomy a large left ovarian mass was noted. A specimen of total abdominal hysterectomy with unilateral salpingo-oopherectomy was received.Grossly, a solid left ovarian mass of size 9x7x3.5 cm with smooth and lobulated external surface was noted. Cut section was solid, homogenous, yellow to tan in colour [ ABSTRACTSertoli-Leydig cell tumours (SLCTs) are rare sex cord stromal neoplasms of ovary accounting for less than 0.5% of all ovarian tumours. These are found in women of all age groups (2-75 y), but are most common in reproductive age group with an average age of 25 y. Mostly these are unilateral, confined to ovaries and usually stage I at the time of clinical diagnosis. The common presenting complaints in these patients are due to either mass occupying lesion (mostly pelviabdominal mass and/or pain) or hormonal production (mostly androgen and more rarely oestrogen). Androgenic manifestations, seen in 80% of patients with SLCT, are virilism, hirsutism, receding hairline, breast atrophy, clitoromegaly, acne, hoarseness of voice, etc. Estrogenic manifestations are precocious puberty, abnormal uterine bleeding, abnormal vaginal bleeding, menstrual irregularities, generalised oedema, weight gain, breast hypertrophy, endometrial hyperplasia, endometrial polyps and endometrial carcinoma. Histologically these are classified (WHO) as well-differentiated, intermediately differentiated, poorly differentiated, with heterologous components and retiform type. Prognosis depends upon degree of tumour differentiation (grading) and tumour extent (staging). We herein report an unusual case of SLCT of ovary with oestrogenic manifestation of menorrhagia.

Clinicpathological study of ovarian tumors: A 5 year study

“…Both cases were considered as borderline tumors as tumors of intermediate differentiation have a malignant potential of 10-11%. 17 We encountered 2 cases of juvenile granulosa cell tumor (1.90%). Both occurring in 18 year old unmarried females.…”

Frozen Section Diagnostic Pitfalls of Sertoli-Leydig Cell Tumor with Heterologous Elements

“…The tumor burden results in a palpable mass on physical examination and secondary nonspecific pains [ 2 , 5 , 8 ]. Potential clinical signs also include menstrual irregularities, dysmenorrhea, and virilization resulting from androgen dysregulation [ 2 , 5 , 6 , 9 ].…”

Sertoli leydig cell tumor with rare form of presentation

“…These are usually unilateral but bilateral tumours can be seen in < 2% of cases. 2 Clinical signs and symptoms of SLCT can be related to either hormonal production or presence of mass- Macroscopically, the majority of SLCTs range in size between 5 and 15 cm in diameter. In addition, SLCTs can be solid, solid and cystic or cystic.…”

“…1 It is suggested to be arising either from gonadal mesenchyme of ovary or from remnants of hilum. 2 …”