CASE REPORT
Ovarian Sertoli-Leydig cell tumour with α-fetoprotein-producing intestinal glandular cells. Clinical case and short review of basic literature
 
More details
Hide details
1
Clinical Department of the Clinic of Endocrine Gynaecology, Jagiellonian University Medical College, Krakow, Poland
 
2
Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland
 
 
Submission date: 2019-02-03
 
 
Acceptance date: 2019-02-05
 
 
Publication date: 2019-12-07
 
 
Pol J Pathol 2019;70(3):226-231
 
KEYWORDS
TOPICS
ABSTRACT
Sertoli Leydig cell tumor of the ovary, is a rare neoplasm from the group of sex cord-stromal tumors of the ovary, accounting for less than 1% of all ovarian tumors. Among the Sertoli Leydig cell tumors, we distinguish a separate group of tumors secreting α-fetoprotein (AFP). The young 24-year-old woman presented to the Clinical Department of Gynaecological Endocrinology at the University Hospital in Krakow due to secondary amenorrhea, hirsutism and worsening abdominal pain for several months. During the admission draws attention was drawn to the abnormal level of testosterone, AFP and the revised structure of the ovary in the ultrasound. After a preliminary diagnosis, expanded pelvic MRI was performed, which found an isolated tumor derived from Sertoli Leydig cells. The patient was enrolled to unilaterally remove the right ovary by laparotomy. Histopathological examination and immunohistochemical staining confirmed the diagnosis of Sertoli Leydig cells tumor, and in pathological examination we found glandular mucosa cells of the colon. Owing to scientific reports on the stromal tumors of the ovary, we decided to perform genetic testing and verify the patient’s karyotype. In the follow-up 90 days after the surgery, levels of testosterone and AFP were correct. In case of Sertoli Leydig cell tumors, especially in young women of childbearing potential, special attention should be paid to Anti-Mullerian hormone testing before surgery, as well as genetic diagnostics to exclude disorders of sex development.
REFERENCES (33)
1.
Gut P, Waligórska-Stachura J, Czarnywojtek A, et al. Management of the hormonal syndrome of neuroendocrine tumors. Arch Med Sci 2017; 13: 515-524.
 
2.
Horta M, Cunha TM, Marques RC, Félix A. Ovarian Sertoli-Leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review. J Radiol Case Rep 2014; 8: 30-41.
 
3.
Jashnani KD, Hegde CV, Munot SP. Alfa-fetoprotein secreting ovarian sex cord-stromal tumor. Indian J Pathol Microbiol 2013; 56: 54-56.
 
4.
Shu H, Yang Xh, Gao AF. Ovarian Sertoli-Leydig cell tumor in a 9-month-old infant with special histologic pattern. Fetal Pediatr Pathol 2012; 31: 388-393.
 
5.
Poli UR, Swarnalata G, Maturi R, Rao ST. Recurrent alpha-fetoprotein secreting Sertoli-Leydig cell tumor of ovary with an unusual presentation. Indian J Cancer 2009; 46: 64-66.
 
6.
Watanabe T, Yamada H, Morimura Y, et al. Ovarian Sertoli-Leydig cell tumor with heterologous gastrointestinal epithelium as a source of alpha-fetoprotein: a case report. J Obstet Gynaecol Res 2008; 34: 418-421.
 
7.
Jang KT, Park HR, Kim DH, Kim CM. Alfa-fetoprotein producing Sertoli-Leydig cell tumor of the ovary: A case report. Korean J Pathol 2002; 36: 128-131. Available at: www.koreanjpathol.org/upload/journal/2002/2002_0128.pdf.
 
8.
Mooney EE, Nogales FF, Tavassoli FA. Hepatocytic differentiation in retiform Sertoli-Leydig cell tumors: distinguishing a heterologous element from Leydig cells. Hum Pathol 1999; 30: 611-617.
 
9.
Golbang P, Khan A, Scurry J, et al. Cervical sarcoma botryoides and ovarian Sertoli-Leydig cell tumor. Gynecol Oncol 1997; 67: 102-106.
 
10.
Singh ZN, Singh MK, Chopra P. Sertoli-Leydig cell tumor with malignant heterologous elements and raised alpha-fetoprotein: a case report. J Obstet Gynaecol Res 1996; 22: 595-598.
 
11.
Hammad A, Jasnosz KM, Olson PR. Expression of alpha-fetoprotein by ovarian Sertoli-Leydig cell tumors. Case report and review of the literature. Arch Pathol Lab Med 1995; 119: 1075-1079.
 
12.
Amato G, Izzo G, Izzo A. A paradoxical inhibition of androgenic hyperproduction by a Sertoli-Leydig cell tumour ovary. Hum Reprod 1995; 10: 2967-2969.
 
13.
Farley JH, Taylor RR, Bosscher JR. Late presentation of an alpha-fetoprotein secreting isolated large upper abdominal retroperitoneal Sertoli-Leydig cell tumor recurrence. Gynecol Oncol 1995; 56: 319-322.
 
14.
Larsen WG, Felmar EA, Wallace ME, Frieder R. Sertoli-Leydig cell tumor of the ovary: a rare cause of amenorrhea. Obstet Gynecol 1992; 79 (5 Pt 2): 831-833.
 
15.
Ohyama N, Yamamoto Y, Tanaka K, et al. A case of ovarian Sertoli-Leydig cell tumor associated with high serum alpha-fetoprotein (AFP) concentration. Nihon Sanka Fujinka Gakkai Zasshi 1990; 42: 637-640.
 
16.
Motoyama I, Watanabe H, Gotoh A, et al. Ovarian Sertoli-Leydig cell tumor with elevated serum alpha-fetoprotein. Cancer 1989; 63: 2047-2053.
 
17.
Gagnon S, T˜tu B, Silva EG, McCaughey WT. Frequency of alpha-fetoprotein production by Sertoli-Leydig cell tumors of the ovary: an immunohistochemical study of eight cases. Mod Pathol 1989; 2: 63-67.
 
18.
Taniyama K, Suzuki H, Hara T, et al. An alpha-fetoprotein producing Sertoli-Leydig cell tumor – a case report. Gan No Rinsho 1989; 35: 107-113.
 
19.
Chadha S, Honnebier WJ, Schaberg A. Raised serum alpha-fetoprotein in Sertoli-Leydig cell tumor (androblastoma) of ovary: report of two cases. Int J Gynecol Pathol 1987; 6: 82-88.
 
20.
Tiltman A, Dehaeck K, Soeters R, et al. Ovarian Sertoli-Leydig cell tumour with raised serum alpha fetoprotein. A case report. Virchows Arch A Pathol Anat Histopathol 1986; 410: 107-112.
 
21.
Tetu B, Ordó¼ez NG, Silva EG. Sertoli-Leydig cell tumor of the ovary with alpha-fetoprotein production. Arch Pathol Lab Med 1986; 110: 65-68.
 
22.
Mann WJ, Chumas J, Rosenwaks Z, et al. Elevated serum alpha-fetoprotein associated with Sertoli-Leydig cell tumors of the ovary. Obstet Gynecol 1986; 67: 141-144.
 
23.
Sekiya S, Inaba N, Iwasawa H, et al. AFP-producing Sertoli-Leydig cell tumor of the ovary. Arch Gynecol 1985; 236: 187-196.
 
24.
Young RH, Perez-Atayde AR, Scully RE. Ovarian Sertoli-Leydig cell tumor with retiform and heterologous components. Report of a case with hepatocytic differentiation and elevated serum alpha-fetoprotein. Am J Surg Pathol 1984; 8: 709-718.
 
25.
Chumas JC, Rosenwaks Z, Mann WJ, et al. Sertoli-Leydig cell tumor of the ovary producing alpha-fetoprotein. Int J Gynecol Pathol 1984; 3: 213-219.
 
26.
Benfield GF, Tapper-Jones L, Stout TV. Androblastoma and raised serum alpha-fetoprotein with familial multinodular goitre. Case report. Br J Obstet Gynaecol 1982; 89: 323-326.
 
27.
Tanaka YO, Tsunoda H, Kitagawa Y, et al. Functioning ovarian tumors: direct and indirect findings at MR imaging. Radiographics 2004; 24 (Suppl 1): S147-S166.
 
28.
Outwater EK, Wagner BJ, Mannion C, et al. Sex cord-stromal and steroid cell tumors of the ovary. Radiographics 1998; 18: 1523-1546.
 
29.
Pratt J. Pathology of the Ovary. 1st ed. Germ cell tumours sex cord-stromal tumors. Sounders, Philadelphia 2004; 219-225, 261-262.
 
30.
Bhat RA, Lim YK, Chia YN, Yam KL. Sertoli-Leydig cell tumor of the ovary: analysis of a single institution database. J Obstet Gynaecol Res 2013; 39: 305-310.
 
31.
Gui T, Cao D, Shen K, et al. A clinicopathological analysis of 40 cases of ovarian Sertoli-Leydig cell tumors. Gynecol Oncol 2012; 127: 384-389.
 
32.
Salani R, Backes FJ, Fung MF, et al. Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncologists recommendations. Am J Obstet Gynecol 2011; 204: 466-478.
 
33.
Morgan RJ, Jr, Alvarez RD, Armstrong DK, et al. National comprehensive cancer networks. Ovarian cancer, version 2.2013. J Natl Compr Canc Netw 2013; 11: 1199-1209.
 
eISSN:2084-9869
ISSN:1233-9687
Journals System - logo
Scroll to top