Obstet Gynecol Sci.  2017 Jan;60(1):39-45. 10.5468/ogs.2017.60.1.39.

A novel clinicopathological analysis of early stage ovarian Sertoli-Leydig cell tumors at a single institution

• Nam SM
• Kim JW
• Eoh KJ
• Kim HM
• Lee JY
• Nam EJ
• Kim S
• Kim SW
• Kim YT

• KMID: 2383206
• DOI: http://doi.org/10.5468/ogs.2017.60.1.39

Abstract

OBJECTIVE
To evaluate the clinical and pathologic characteristics of patients who were diagnosed with ovarian Sertoli-Leydig cell tumors (SLCTs) in a single institution.
METHODS
The medical records of 11 patients who were pathologically diagnosed with SLCTs beginning in 1995 in a single institute was reviewed.
RESULTS
The median patient age was 31 years (range, 16 to 70 years). Patient International Federation of Gynecology and Obstetrics stages were IA, IC, and IIB in 3 (27.3%), 6 (54.5%), and 2 (18.2%) patients, respectively. Six patients (54.5%) had grade 3 tumors, 3 patients (27.3%) had grade 2 tumors, and 1 patient (9.1%) had a grade 1 tumor. Four patients without children underwent fertility-sparing surgery, and 7 patients had full staging surgery, including a hysterectomy and bilateral salpingo-oophorectomy, with a laparoscopic approach used in 3. Eight patients underwent pelvic lymph node dissection, and 8 patients were administered adjuvant chemotherapy consisting of bleomycin, etoposide, and cisplatin in 6 cases, a modified bleomycin, etoposide, and cisplatin regimen in 1 case, and a combined paclitaxel and cisplatin regimen in 1 case. Two patients died of disease and were re-diagnosed with Sertoli form endometrioid carcinoma. The other patients remain alive without recurrence at the time of reporting.
CONCLUSION
Our findings suggest that regardless of tumor stage or grade, ovarian SLCT patients have a good prognosis. Close observation and unilateral salpingo-oophorectomy would be beneficial for women who still wish to have children, while hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemotherapy would be the optimal treatment in other cases. Furthermore, meticulous pathologic diagnosis is needed to develop a precise treatment strategy.

Keyword

Drug therapy; Histology; Ovarian neoplasms; Sertoli-Leydig cell tumor

MeSH Terms

Bleomycin
Carcinoma, Endometrioid
Chemotherapy, Adjuvant
Child
Cisplatin
Diagnosis
Drug Therapy
Etoposide
Female
Gynecology
Humans
Hysterectomy
Lymph Node Excision
Medical Records
Obstetrics
Ovarian Neoplasms
Paclitaxel
Prognosis
Recurrence
Sertoli-Leydig Cell Tumor*
Bleomycin
Cisplatin
Etoposide
Paclitaxel

Figure

• 

  Fig. 1 Pathology of Sertoli-Leydig cell tumor. There are solid tumors with round uniform cells vacuolated or pink granular cytoplasma and pigment (H&E, ×200).

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  Fig. 2 Sertoliform endometrioid carcinoma. The pathologic feature is similar to the Sertoli-Leydig cell tumors (H&E, ×200).

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