18 Sertoli-leydig cell tumors of the ovary: analysis of a single institution database

Background: An improved understanding of the clinical presentations, histological character, and therapeutic approaches relevant to ovarian Sertoli-Leydig cell tumors (SLCTs), is of value to better treat this disease. Methods: We reviewed the medical records of 18 ovarian SLCT patients seen in our center over the last 10 years. Combined with available literature, we conducted a retrospective study and analysis of this patient group. Results: We observed that the patients initially presented at ages ranging from 23 to 72 years, displayed various clinical disease manifestations, and all patients were diagnosed with stage I tumors. Most tumors were solid masses, unilateral lesions, and carried a favorable prognosis. Conclusions: Data gathered favor both improved clinical management and better prognostic for patients with SLCT.

ovary; Sertoli-Leydig cell tumors; clinicopathological characteristics; surgery; prognosis

[1] Mayr D, Schmoeckel E, Höhn AK, Hiller GGR, Horn LC. Current WHO classification of the female genitals: Many new things, but also some old. Pathologe. 2021; 42: 259–269.

[2] Boussios S, Moschetta M, Zarkavelis G, Papadaki A, Kefas A, Tatsi K. Ovarian sex-cord stromal tumours and small cell tumours: Pathological, genetic and management aspects. Critical Reviews in Oncology/Hematology. 2017; 120: 43–51.

[3] Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. International Journal of Gynecology & Obstetrics. 2009; 105: 103–104.

[4] Young RH, Scully RE. Ovarian Sertoli - Leydig cell tumors. A clinicopathological analysis of 207 cases. The American Journal of Surgical Pathology. 1985; 9: 543–569.

[5] Boussios S, Moschetta M, Tatsi K, Tsiouris AK, Pavlidis N. A review on pregnancy complicated by ovarian epithelial and non-epithelial malignant tumors: Diagnostic and therapeutic perspectives. Journal of Advanced Research. 2018; 12: 1–9.

[6] Durmuş Y, Kılıç C, Çakır C, Yüksel D, Boran N, Karalök A, et al. Sertoli–Leydig cell tumor of the ovary: Analysis of a single institution database and review of the literature. Journal of Obstetrics and Gynaecology Research. 2019; 45: 1311–1318.

[7] Lou W, Cao D, Yang J, Guo L, Shen K. Retiform Sertoli–Leydig cell tumor of ovary in a 9-year-old girl: case report and review of the literature. International Journal of Clinical Oncology. 2011; 16: 705–708.

[8] Stegner H-E, Lisboa BP. Steroid metabolism in an androblastoma (Sertoli-Leydig cell tumour). A histopathological and biochemical study. International Journal of Gynecological Pathology.1984; 2: 410–425.

[9] Zhang HY, Zhu JE, Huang W, Zhu J. Clinicopathologic features of ovarian Sertoli- Leydig cell tumours. International Journal of Clinical and Experimental Pathology. 2014; 7: 6956–6964.

[10] Seidman JD, Patterson JA, Bitterman P. Sertoli-Leydig cell tumour associated with a mature cystic teratoma in a single ovary. Modern Pathology. 1989; 2: 687–692.

[11] Nam SM, Kim JW, Eoh KJ, Kim HM, Lee JY, Nam EJ, et al. A novel clinicopathological analysis of early stage ovarian Sertoli-Leydig cell tumors at a single institution. Obstetrics & Gynecology Science. 2017; 60: 39.

[12] Weng C, Chen M, Wang T, Tsai H, Hung Y, Yu K, et al. Sertoli–Leydig cell tumors of the ovary: a Taiwanese Gynecologic Oncology Group study. Taiwanese Journal of Obstetrics and Gynecology. 2013; 52: 66–70.

[13] Nef J, Huber DE. Ovarian Sertoli–Leydig cell tumours: a systematic review of relapsed cases. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021; 263: 261–274.

[14] Monappa V, Reddy SM, Kudva R, Pai MV. Cystic Sertoli-Leydig Cell Tumour in a Postmenopausal Woman with Absent Virilising Symptoms: A Diagnostic Challenge. Journal of Clinical and Diagnostic Research.2017; 11: 26–28.

[15] Chen L, Tunnell CD, De Petris G. Sertoli–Leydig cell tumor with heterologous element: a case report and a review of the literature. International Journal of Clinical and Experimental Pathology. 2014; 7: 1176–1181.

[16] Bhat RA, Lim YK, Chia YN, Yam KL. Sertoli-Leydig cell tumor of the ovary: Analysis of a single institution database. Journal of Obstetrics and Gynaecology Research. 2013; 39: 305–310.

[17] Gui T, Cao D, Shen K, Yang J, Zhang Y, Yu Q, et al. A clinicopathological analysis of 40 cases of ovarian Sertoli–Leydig cell tumors. Gynecologic Oncology. 2012; 127: 384–389.

[18] Colombo N, Peiretti M, Castiglione M. Non-epithelial ovarian cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Annals of Oncology. 2009; 20: iv24–iv26.

[19] McCluggage WG, McKenna M, McBride HA. CD56 is a Sensitive and Diagnostically Useful Immunohistochemical Marker of Ovarian Sex Cord-Stromal Tumors. International Journal of Gynecological Pathology. 2007; 26: 322–327.

[20] Sigismondi C, Gadducci A, Lorusso D, Candiani M, Breda E, Raspagliesi F, et al. Ovarian Sertoli-Leydig cell tumors. a retrospective MITO study. Gynecologic Oncology. 2012; 125: 673–676.

[21] Chen FY, Sheu BC, Lin MC, Chow SN, Lin HH. Sertoli-Leydig cell tumor of the ovary. Journal of the Formosan Medical Association. 2004; 103: 388–391.

[22] Chen L, Tunnell CD, De Petris G. Sertoli-Leydig cell tumor with heterologous element: a case report and a review of the literature. International Journal of Clinical and Experimental Pathology. 2014; 7: 1176–1181.

[23] Singh C, Ahmad S, Hajjar FM, Holloway RW. Poorly differentiated, ovarian Sertoli-Leydig cell tumor with heterologous rhabdomyosarcoma and glandular elements: Diagnosis and management of a rare neoplasm. Gynecologic Oncology Reports. 2018; 25: 70–73.

[24] Al-Hussaini M, Al-Othman Y, Hijazi E, McCluggage WG. A Report of Ovarian Sertoli-Leydig Cell Tumors with Heterologous Intestinal-type Glands and Alpha Fetoprotein Elevation and Review of the Literature. International Journal of Gynecological Pathology. 2018; 37: 275–283.

[25] Karnezis AN, Wang Y, Keul J, Tessier-Cloutier B, Magrill J, Kommoss S, et al. DICER1 and FOXL2 Mutation Status Correlates with Clinicopatho-logic Features in Ovarian Sertoli-Leydig Cell Tumors. American Journal of Surgical Pathology. 2019; 43: 628–638.

[26] Zheng XZ, Ma JH, Chen TB, Xu F, Zou ZY, Zhang LH. Application of molecular analysis in differential diagnosis of ovarian adult granulosa cell tumors. Zhonghua Bing Li Xue Za Zhi. 2020; 49: 794–799. (In Chinese)

[27] Cheung A, Shah S, Parker J, Soor P, Limbu A, Sheriff M, et al. Non-Epithelial Ovarian Cancers: How Much Do We Really Know?International Journal of Environmental Research and Public Health. 2022; 19: 1106.