We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
253 Ovarian Sertoli-Leydig Cell Tumor Presenting With Nonspecific Symptoms, in an Elderly Patient With Family History of Gastrointestinal Stromal Tumor.
- Authors
Haque, Monira; Hameed, Nadia; Mneimneh, Wadad
- Abstract
Objectives: Sertoli-Leydig cell tumors (SLCTs) of the ovary are rare sex cord stromal tumors, accounting for less than 0.1% of ovarian tumors. SLCTs typically occur in young women and usually manifest with symptoms related to androgen excess. We present the case of a 75-year-old female patient with a family history of gastrointestinal stromal tumor (GIST) in the brother. Methods: Clinically, she presented with abdominal swelling, weight loss and severe heartburn. Computed tomography revealed a heterogeneously hypoechoic, solid and cystic mass extending from the pelvis to upper abdomen, with a differential diagnosis including, mainly, an ovarian primary and GIST. The patient's serum CA-125 was found to be 342 U/mL (reference range <35 U/mL). The patient underwent exploratory laparotomy, which revealed a 35 cm mass arising from the right ovary and focally adherent to the colon and ileum. Results: Grossly, the mass was received partially ruptured, demonstrating a variegated appearance with tan-yellow solid and cystic cut surface, and areas of necrosis and hemorrhage. Microscopically, the tumor consisted of cellular, closely intermixed, epithelioid and spindle cell components. The spindle cell areas were edematous, merging within more compact epithelioid component, resulting in a trabecular pattern, with rare scattered eosinophilic cells reminiscent of Leydig cells. Sarcomatoid areas with spindle cell fascicular growth pattern were seen, as well as solid, cellular, epithelioid areas, with high nuclear to cytoplasmic ratio, hyperchromasia, abundant mitoses and necrosis. Heterologous elements were not demonstrated. Immunohistochemically, the cells were variably positive for inhibin, calretinin, WT-1, and Mart-1, weakly positive for ER, and negative for EMA, CD34, CD117, CD10, Desmin, AE1-AE3, and Cyclin-D1. The diagnosis of poorly differentiated SLCT was made. Conclusion: In addition to the fact that ovarian SLCT is extremely rare, our case is peculiar due to its uncommon presentation in an elderly woman with family history of GIST, with non-androgenic clinical manifestations.
- Subjects
IMMUNOHISTOCHEMISTRY; SERTOLI cells
- Publication
American Journal of Clinical Pathology, 2018, Vol 149, pS107
- ISSN
0002-9173
- Publication type
Article
- DOI
10.1093/ajcp/aqx123.252