title: Sertoli-Leydig cell tumor presenting hyperestrogenism in a postmenopausal woman: a case report and review of the literature.
abstract: OBJECTIVE
  Sertoli-Leydig cell tumor (SLCT) accounts for <0.5% of all ovarian tumors, which is unusual in postmenopausal women. Postmenopausal women with SLCT usually become virilized. We report a postmenopausal woman with SLCT presenting with hyperestrogenism.
  
  
  METHODS
  We report a rare case of SLCT in a postmenopausal woman aged 61 years, who presented with postmenopausal bleeding, endometrial hyperplasia and mucous polyp, elevated estradiol, and decreased follicle-stimulating hormone (FSH) and luteinizing hormone (LH) values, all suggesting hyperestrogenism. Transvaginal ultrasound revealed several small cyst locules, detected inside the right ovary, with a maximum diameter of 7 mm. The diagnosis was delayed because of the atypical clinical manifestation and negative serum tumor markers. The frozen section investigation revealed SLCT intraoperatively, which was confirmed by histopathological and immunocytochemical examination. The tumor was positive for inhibin-alpha, pancytokeratin, and p53 and in isolated tumor cells, positive for Ki-67.
  
  
  CONCLUSIONS
  This case of SLCT suggests the existence of a new specific type of endocrine complex disease.
authors.affiliation: Shanghai First Maternity and Infant Hospital, Tongji University, School of Medicine, Shanghai, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Guo
authors.forename: Xiang
authors.initials: X
authors.lastname: Yang
authors.forename: Huiting
authors.initials: H
authors.lastname: Zhu
authors.forename: Weimin
authors.initials: W
authors.lastname: Qiu
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Shi
authors.forename: Bingqing
authors.initials: B
authors.lastname: Huang
authors.forename: Tao
authors.initials: T
authors.lastname: Duan
mesh_terms: D004958:Estradiol / Q000097:blood; D004967:Estrogens / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D017698:Postmenopause / Q000097:blood; D018310:Sertoli-Leydig Cell Tumor / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D014592:Uterine Hemorrhage / Q000209:etiology
chemical_list: D004967:Estrogens; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone