Ovarian Sertoli-Leydig cell tumour

Ovarian Sertoli-Leydig cell tumours (SLCT), also known as an ovarian androblastomas, are a subtype of ovarian sex cord-stromal tumour.

They are rare and only account for ~0.5% of all ovarian tumours. While they can present at any age, they typically present <30 years old, with a mean age of 14 years.

In ~30-50% of patients, the presenting symptoms are related to clinical signs of androgenic activity 6. Many patients have symptoms of virilization depending on the quantity of androgen production. A small subset are hyperoestrogenic.

Hormonally inactive tumours often have a nonspecific presentation such as an abdominal mass and/or pain. The majority of patients present with stage I disease.

Most tumours are unilateral (>90% of cases) and confined to the ovaries. These tumours are characterised by the presence of testicular structures that produce androgens. However, only 30% are hormonally active.

Ovarian SLCTs can be divided into four subtypes:

  • well differentiated
  • intermediately differentiated
  • poorly differentiated
  • retiform

The tumours may contain heterologous elements in approximately 20% of cases. These can, in turn, be further separated into two basic types: endodermal and mesenchymal. Heterologus hepatic differentiation is responsible for elevated AFP levels 11.

Variants

SLCTs are usually unilateral.

Ultrasound

Imaging features are nonspecific and variable. SLCT may manifest as a well-defined, enhancing solid mass 3 or as a cystic lesion 6. It typically presents as a solid mass with intratumoural cysts.

MRI

The signal intensity on T2-weighted MR images depends on their fibrous content. Most tumours demonstrate predominantly low T2 signal intensity with scattered areas of high signal intensity 5.

Most tumours are benign although ~10-20% can be malignant.

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Article information

rID: 15456
System: Gynaecology
Synonyms or Alternate Spellings:
  • Ovarian Sertoli-Leydig cell tumor
  • Ovarian androblastoma
  • Androblastoma of the ovary
  • Androblastoma of ovary
  • Ovarian Sertoli-Leydig cell tumour (SLCT)

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    Case 1: in left ovary
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