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
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.
SLCTs are usually unilateral.
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.
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.
Treatment and prognosis
Most tumours are benign although ~10-20% can be malignant.
- 1. Tandon R, Goel P, Saha PK et-al. A rare ovarian tumor - Sertoli-Leydig cell tumor with heterologous element. MedGenMed. 2007;9 (4): 44. - Free text at pubmed - Pubmed citation
- 2. Caringella A, Loizzi V, Resta L et-al. A case of Sertoli-Leydig cell tumor in a postmenopausal woman. Int. J. Gynecol. Cancer. 16 (1): 435-8. doi:10.1111/j.1525-1438.2006.00203.x - Pubmed citation
- 3. Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
- 4. Tanaka YO, Tsunoda H, Kitagawa Y et-al. Functioning ovarian tumors: direct and indirect findings at MR imaging. Radiographics. 2004;24 Suppl 1 : S147-66. doi:10.1148/rg.24si045501 - Pubmed citation
- 5. Shanbhogue AK, Shanbhogue DK, Prasad SR et-al. Clinical syndromes associated with ovarian neoplasms: a comprehensive review. Radiographics. 30 (4): 903-19. doi:10.1148/rg.304095745 - Pubmed citation
- 6. Jung SE, Rha SE, Lee JM et-al. CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol. 2005;185 (1): 207-15. AJR Am J Roentgenol (full text) - Pubmed citation
- 7. Roth LM, Anderson MC, Govan AD et-al. Sertoli-Leydig cell tumors: a clinicopathologic study of 34 cases. Cancer. 1981;48 (1): 187-97. - Pubmed citation
- 8. Dähnert W. Radiology Review Manual. Lippincott Williams & Wilkins. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
- 9. Young RH, Scully RE. Ovarian Sertoli-Leydig cell tumors. A clinicopathological analysis of 207 cases. Am. J. Surg. Pathol. 1985;9 (8): 543-69. - Pubmed citation
- 10. Zizi-sermpetzoglou A, Petrakopoulou N, Tepelenis N et-al. Pure Sertoli cell tumor. a case report and review of the literature. Eur. J. Gynaecol. Oncol. 2010;31 (1): 117-9. - Pubmed citation
- 11. Heo SH, Kim JW, Shin SS et-al. Review of ovarian tumors in children and adolescents: radiologic-pathologic correlation. Radiographics. 2014;34 (7): 2039-55. doi:10.1148/rg.347130144 - Pubmed citation