Abstract
To describe a series of cases of ovarian Sertoli-Leydig cell tumors (SLCTs). Retrospective review of 12 cases of SLCT treated at the Hospital do Câncer de Barretos, Barretos, state of São Paulo, Brazil, between October 2009 and August 2017. The median age of the patients was 31 years old (15-71 years old). A total of 9 patients (75.0%) presented symptoms: 8 (66.7%) presented with abdominal pain, 5 (41.7%) presented with abdominal enlargement, 2 (16.7%) presented with virilizing signs, 2 (16.7%) presented with abnormal uterine bleeding, 1 (8.3%) presented with dyspareunia, and 1 (8.3%) presented with weight loss. The median preoperative lactate dehydrogenase (LDH) was 504.5 U/L (138-569 U/L), alpha-fetoprotein (AFP) was 2.0 ng/ml (1.1-11.3 ng/ml), human chorionic gonadotropin (β-hCG) was 0.6 mUI/ml (0.0-2.3 mUI/ml), carcinoembryonic antigen (CEA) was 0.9 ng/ml (0.7-3.4 ng/ml), and cancer antigen 125 (CA-125) was 26.0 U/ml (19.1-147.0 U/ml). All of the tumors were unilateral and surgically treated. Lymphadenectomy was performed in 3 (25.0%) patients, but none of the three patients submitted to lymphadenectomy presented lymph node involvement. In the anatomopathological exam, 1 (8.3%) tumor was well-differentiated, 8 (66.7%) were moderately differentiated, and 3 (25.0%) were poorly differentiated. A total of 5 (55.6%) tumors were solid-cystic, 2 (22.2%) were purely cystic, 1 (11.1%) was cystic with vegetations, and 1 (11.1%) was purely solid, but for 3 patients this information was not available. The median lesion size was 14.2 cm (3.2-23.5 cm). All of the tumors were at stage IA of the 2014 classification of the International Federation of Gynecology and Obstetrics (FIGO). A total of 2 (16.7%) patients received adjuvant treatment; 1 of them underwent 3 cycles of paclitaxel and carboplatin every 21 days, and the other underwent 4 cycles of ifosfamide, cisplatin and etoposide every 21 days. None of all of the patients had recurrence, and one death related to complications after surgical staging occurred. Abdominal pain was the most frequent presentation. There was no ultrasonographic pattern. All of the SLCTs were at stage IA, and most of them were moderately differentiated. Relapses did not occur, but one death related to the surgical staging occurred.
Highlights
Ovarian Sertoli-Leydig cell tumors (SLCTs) are part of the sexual cord neoplasms and represent < 0.5% of all ovarian tumors.[1]
All of the SLCTs were at stage IA, and most of them were moderately differentiated
Research Variables In the present study, we evaluated epidemiological, clinical, and prognostic data related to ovarian SLCTs
Summary
Ovarian Sertoli-Leydig cell tumors (SLCTs) are part of the sexual cord neoplasms and represent < 0.5% of all ovarian tumors.[1] This type of tumor predominates in the 2nd and 3rd decades of life and usually presents with hormonal changes, including signs of virilization, such as amenorrhea, hirsutism, acne, and male pattern of pilification.[2,3,4,5,6,7,8] These characteristics are due to an increase in androgen production by tumor cells. In patients without hormonal manifestations, the typical presentation of the disease consists of abdominal pain and increased abdominal circumference, usually with a palpable adnexal mass at physical examination.[10] Some authors suggest that the preoperative diagnosis in patients without association of signs of virilization and palpable abdominal mass would be practically impossible.[2]
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