Use of novel serum markers in clinical follow-up of Sertoli-Leydig cell tumours.
BACKGROUND
Sertoli-Leydig cell tumours of the ovary account for only 0.2% of malignant ovarian tumours. Two-thirds of all patients become apparent due to the tumour's hormone production.


METHODS
A 41-year-old patient (gravida 4, para 4) presented with dyspnoea, enlarged abdominal girth and melaena. Diagnostic imaging was suspicious for an ovarian cancer. The standard tumour marker for ovarian cancer (CA 125) was elevated to 984 U/mL.


RESULTS
Surgical exploration of the abdomen revealed a mouldering tumour of both adnexes extending to the level of the navel. Frozen sections showed an undifferentiated carcinoma of unknown origin. Radical surgery was performed. The final histological report described a malignant sex-cord stroma tumour, a Sertoli-Leydig cell tumour, emanating from both ovaries. Analysis of preoperative blood serum showed elevated levels of CYFRA 21-1 (10.4 ng/mL), neuron-specific enolase (36.2 ng/mL), oestradiol (485 pg/mL) and CA-125 (984 U/mL). Adjuvant chemotherapy and regional hyperthermia were performed due to the malignant potential and incomplete resection of the tumour.


CONCLUSIONS
Undifferentiated Sertoli-Leydig cell tumours show a poor clinical course. As only two-thirds of patients with this rare disease present with elevated hormone levels, new markers deserve further investigation to offer more specific, individualised tumour monitoring.
Lenhard
Miriam
M
Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany. miriam.lenhard@med.uni-muenchen.de
Kuemper
Caroline
C
Ditsch
Nina
N
Diebold
Joachim
J
Stieber
Petra
P
Friese
Klaus
K
Burges
Alexander
A
D000328:Adult; D000951:Antigens, Neoplasm / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053539:Keratin-19; D007633:Keratins / Q000097:blood; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010751:Phosphopyruvate Hydratase / Q000097:blood; D018310:Sertoli-Leydig Cell Tumor / Q000175:diagnosis*
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D053539:Keratin-19; C102012:antigen CYFRA21.1; D004958:Estradiol; D007633:Keratins; D010751:Phosphopyruvate Hydratase