Ovarian sertoli-leydig cell tumour of intermediate-differentiation with heterologous elements comprising of seromucinous epithelial lined cysts and immature neural tissue: an unusual neoplasm

Abstract

Ovarian Sertoli-Leydig cell tumour (SLCT) is a rare sex cord stromal tumour. Some SLCT, usually of intermediate or poor differentiation show heterologous elements such as gastrointestinal type epithelium, immature cartilage or skeletal muscle. However, SLCT with serous epithelium and immature neural tissue as heterologous elements have not been documented. We describe a rare ovarian SLCT with heterologous elements in a 25-year-old woman with post-partum abdominal swelling and pain. Heterologous elements included cystic locules lined by a benign epithelium of serous and mucinous cells and a small foci of immature neural tissue. SCLT withheterologousmucinous elementsshouldbedistinguished from pure mucinous cystic ovarian tumours which may appear similar macroscopically and present with virilising symptoms. Heterologous elements may present in a variable proportion from microscopic foci to predominant tumour masking the SLCT. This case highlights the importance of extensive sampling because of common and overlapping morphological features with other ovarian tumours.