Clinical analysis of Sertoli-Leydig cell tumors

Abstract

Objective To investigate the clinical manifestations and pathological features of ovarian Sertoli-Leydig cell tumors (SLCTs), so as to improve the recognition of this disease. Methods From January 1, 2011 to December 31, 2017, 6 patients with ovarian SLCTs who were diagnosed by pathological examination at the West China Second University Hospital, Sichuan University were selected as the research subjects. Their age ranged from 24 to 57 years old. The clinical data of those 6 patients were collected so as to summarize clinical characteristics, pathological examination results, auxiliary examination results, immunohistochemical results, and the process of diagnosis and treatment of SLCTs by retrospective analysis method. This study met the requirements of the World Medical Association Declaration of Helsinki revised in 2013. Results ①Among 6 ovarian SLCTs patients, all the tumors occurred in the unilateral ovary. Only 2 cases of the 6 patients had visible tumors to the naked eye during the operation. And the remaining 4 cases, the Sertoli-Keydig cells were observed under the light microscope, without obvious abnormality in appearance. ② Six patients were staged by the International Federation of Obstetrics and Gynecology (FIGO), all in ⅠA phase. There were 2 cases with high differentiation, 2 cases with middle differentiation (patient 2 with reticular component) and 2 cases with unclear degree of differentiation. ③ Immunohistochemical results of 6 patients showed that α-inhibin was positive in 6 patients, calretinin (CR) was positive in 4 patients, vimentin (VIM) was positive in 3 patients, CD99 was positive in 3 patients, CD10 was negative in 3 patients, epithelial membrane antigen (EMA) was negative in 4 patients, and Ki-67≤5% in 5 patients. ④ Testosterone levels increased in two cases before operation and decreased to normal in one case after operation. Among 6 patients, 5 showed adnexa uteri space-occupying by ultrasouad examination. ⑤Among them, patient 2 had ovarian moderately differentiated SLCTs with reticular components, underwent ipsilateral adnexectomy, and received three courses of BEP chemotherapy regimen (bleomycin + etoposide + cisplatin) after surgery. All the patients were followed up for 9 to 79 months, and none of them had recurrence. Conclusions Ovarian SLCTs are extremely rare. Preoperative testosterone levels combined with ultrasound examination results can help diagnose. Postoperative biopsy findings are of great significance to the diagnosis, surgical plan, and prognosis of ovarian SLCTs. Patients with earlier FIGO staging have a better prognosis. Key words: Ovary; Sertoli-Leydig cell tumor; Pathology; Diagnosis; Testosterone; Women