Ovarian Sertoli-Leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review.
Here we describe the case of a 19-year-old woman with a poorly differentiated ovarian Sertoli-Leydig cell tumor and an elevated serum alpha-fetoprotein level. The patient presented with diffuse abdominal pain and bloating. Physical examination, ultrasound, and magnetic resonance imaging revealed a right ovarian tumor that was histopathologically diagnosed as a poorly differentiated Sertoli-Leydig cell tumor with heterologous elements. Her alpha-fetoprotein serum level was undetectable after tumor resection. Sertoli-Leydig cell tumors are rare sex cord-stromal tumors that account for 0.5% of all ovarian neoplasms. Sertoli-Leydig cell tumors tend to be unilateral and occur in women under 30 years of age. Although they are the most common virilizing tumor of the ovary, about 60% are endocrine-inactive tumors. Elevated serum levels of alpha-fetoprotein are rarely associated with Sertoli-Leydig cell tumors, with only approximately 30 such cases previously reported in the literature. The differential diagnosis should include common alpha-fetoprotein-producing ovarian entities such as germ cell tumors, as well as other non-germ cell tumors that have been rarely reported to produce this tumor marker.
Serviço de Radiologia, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
Mariana
M
Horta
Serviço de Radiologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
Teresa Margarida
TM
Cunha
Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
Rita Canas
RC
Marques
Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
Ana
A
Félix
D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis*; D018310:Sertoli-Leydig Cell Tumor / Q000097:blood* / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism*
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins
Alpha-fetoprotein; Magnetic resonance; Ovarian tumor; Sertoli-Leydig tumor; Sex cord-stromal tumor; Ultrasound