Huge Sertoli-Leydig cell tumor: a rare case report

Sertoli-Leydig cell tumors (SLCTs), constitute less than 0.5% of all ovarian tumors. SLCT are rare after menopause (less than10%), 75 years, unmarried, postmenopausal since 30 years, presented with complaints of abdominal swelling. On examination, abdominal mass of 36 weeks, hard, immobile felt. Ultrasonography of abdomen showed lobulated solid cystic lesion of size 22 x 15 x 27 cms with bilateral ovaries not separately visualized. Moderate free fluid in the abdomen, suggestive of malignant neoplastic etiology. CECT Abdomen + pelvis suggestive of primary ovarian malignancy with omental deposits and pelvic adenopathy. CA 125- 415.1 Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with huge tumour mass excision (weight 5.25 kg) with umbilical hernia repair. Frozen section suggestive of a huge mass of 30 x 20 x 15 cm, multilobulated, yellowish white tan in colour, solid-cystic in consistency, seen arising from right ovary. Omentum appears normal. Histopathology report s/o- Moderately differentiated Sertoli Leydig cell tumor. Reporting the first, this huge, in this age group with atypical presentation.

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Cytologic Identification of Reinke Crystalloids in Scrapings and Imprints of Fresh Testicular Tumors: A Simple and Rapid Technique for Intraoperative Use

Archives of Pathology & Laboratory Medicine ◽

10.5858/2005-129-e65-ciorci ◽

2005 ◽

Vol 129 (3) ◽

pp. e65-e66 ◽

Cited By ~ 1

Author(s):

Kambridge P. Hribar ◽

Nancy E. Warner ◽

Andy E. Sherrod

Keyword(s):

Leydig Cell ◽

Leydig Cells ◽

Frozen Section ◽

Rapid Identification ◽

Leydig Cell Tumor ◽

Cell Tumor ◽

Testicular Tumors ◽

Intraoperative Diagnosis ◽

Rapid Technique ◽

Leydig Cell Tumors

Abstract Although not required for the diagnosis, crystalloids of Reinke are pathognomonic for Leydig cell tumor. However, conventional frozen section rarely reveals their presence. A method of rapid identification of crystalloids of Reinke could improve the intraoperative diagnosis. We tested the efficacy of touch imprints and scrape smears for the identification of crystalloids in 2 cases of Leydig cell tumor of the testis. Intraoperative smears of the tumors yielded abundant crystals. Scrape cytologic testing was the better method. We speculate that the process of scraping, and to a lesser extent touch imprinting, disrupts the cytoplasm of the Leydig cells and releases the crystalloids. We conclude that cytologic testing is an effective method of identifying crystalloids of Reinke in Leydig cell tumors of the testis.

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Sertoli cell tumor of ovary: A rare case report

10.1055/s-0039-1685324 ◽

2016 ◽

Author(s):

Umesh Jethwani ◽

Divya Jethwani

Keyword(s):

Case Report ◽

Leydig Cell ◽

Cystic Mass ◽

Leydig Cell Tumor ◽

Cell Tumor ◽

Left Ovary ◽

Disease Stage ◽

Ca 125 ◽

Serum Testosterone Level ◽

The Right

Introduction: Sertoli-Leydig cell tumor (SLCT) is a rare ovarian tumor, Constitute less than 0.5% of ovarian tumors. Most tumors are unilateral, confined to the ovaries. They are seen during the second and third decades of life. They are characterized by the presence of testicular structures that produce androgens. Patients have symptoms of virilization (depending on the quantity of androgen). Case Report: A 42-year-old woman presented Amenorrhea for 14 months. Change in her voice for 1 year and Excessive hair growth on her face, chest, and limbs for the last 2 months. She complained of vague abdominal discomfort. No history of anorexia, weight loss, increased libido. Her medical and family history was unremarkable. On examination - Hirsutism and clitoromegaly. Lump of size 10x8 cm palpable in left iliac fossa. Vaginal examination revealed a firm and mobile cystic mass in the right adnexa. An ultrasound examination of the pelvis showed a 17x 13x 9-cm heterogeneous solid cystic mass replacing the left ovary. The right ovary and the uterus were normal. CECT Scan Abdomen-Large heterogenous encapsulated solid soft tissue mass lesions containing areas of calcification arising from left ovary of size 17x13x10.6cm causing displacement of urinary bladder and surrounding bowel loops. Serum testosterone level -2 ng/mL (normal, 0.2–1.2 ng/mL); (DHEAS), CA 125, and alpha fetoprotein (AFP) -normal. On Laparotmy-Large mass of size 17 X 13 cm arising from left adnexa. Uterus and right ovary grossly normal. Total Abdominal hysterectomy, B/L Salpingo-opherectomy and infracolic omentectomy was done. Peritoneal washing were sent for cytologic examination for malignant cells. No liver metastasis. The post operative period was uneventful. Histopathology revealed- confirmed it be Sertoli Leydig cell tumor. 3month follow up – resolution of her virilization symptoms. No increase of her hirsutism. Repeat testosterone levels - within normal range. Conclusion: Only few cases of SLCT have been reported till date Prognosis depends on extent of disease, stage of disease, tumour differentiation, grade. The treatment should be individualized according to the location, state of spread and the patient’s condition.

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Sertoli-Leydig Cell Tumor of the Ovary Masquerading as a Mucinous Adenocarcinoma: A Frozen Section Pitfall

Rare Tumors ◽

10.4081/rt.2017.6861 ◽

2017 ◽

Vol 9 (3) ◽

pp. 101-103

Author(s):

Jonathan E. Zuckerman ◽

Neda A. Moatamed

Keyword(s):

Leydig Cell ◽

Mucinous Adenocarcinoma ◽

Frozen Section ◽

Leydig Cell Tumor ◽

Cell Tumor

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Frozen Section Diagnostic Pitfalls of Sertoli-Leydig Cell Tumor with Heterologous Elements

Case Reports in Pathology ◽

10.1155/2018/5151082 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Ashley Burris ◽

Caleb Hixson ◽

Nathaniel Smith

Keyword(s):

Leydig Cell ◽

Frozen Section ◽

Mucinous Cystadenoma ◽

Leydig Cell Tumor ◽

Cell Tumor ◽

Cystic Neoplasm ◽

Diagnostic Pitfall ◽

Radiologic Imaging ◽

Poorly Differentiated ◽

The Right

A woman in her sixth decade presented with several months of abdominal cramping, decreased appetite, bloating, and increased constipation. Radiologic imaging revealed a 28 cm, multilocular, heterogeneous cystic neoplasm involving the right adnexa. An intraoperative frozen section showed mucinous glandular epithelium, with and without foci of goblet cells, embedded in apparent ovarian stroma. The findings were concerning at least borderline mucinous cystadenoma with possible invasion. Subsequent surgical management and staging were performed. Permanent sections showed a moderately to poorly differentiated Sertoli-Leydig cell tumor (SLCT) with retiform foci and heterologous elements. The discrepancy between frozen and permanent sections was attributable to solely sampling a focus of heterologous elements during intraoperative consultation. The rarity of SLCT and even rarer presence of both heterologous and retiform elements make this concerning frozen section diagnostic pitfall.

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