Question:

Which of the following is true regarding the treatment and prognosis of Sertoli-Leydig cell tumors?
1. There is a well-established standardized therapeutic approach to this type of tumor.
2. Tumor behavior correlates with the stage and degree of differentiation at the time of diagnosis.
3. Patients with a Sertoli-Leydig cell tumor usually have a poor prognosis.
4. Malignant Sertoli-Leydig cell tumors tend to have a late recurrence of the disease.
5. Metastatic recurrence of Sertoli-Leydig cell tumors is common.





Answer:

The correct answer for the question "Which of the following is true regarding the treatment and prognosis of Sertoli-Leydig cell tumors?" is:

2. Tumor behavior correlates with the stage and degree of differentiation at the time of diagnosis.



Explanation
1. There are no standard guidelines for the management of Sertoli-Leydig cell tumors. [Due to the lack of standardized protocol guidelines, there is no uniform therapeutic approach to these tumors.]
2. True. [Tumor behavior correlates with the stage and degree of differentiation at the time of diagnosis.]
3. Patients with a Sertoli-Leydig cell tumor usually have a good prognosis. [Sertoli-Leydig cell tumors are typically associated with a good prognosis.]
4. Malignant Sertoli-Leydig cell tumors tend to have an early recurrence of the disease. [In contrast to other sex cord-stromal tumors, such as granulosa cell tumors, which may have late recurrence of the disease, malignant Sertoli-Leydig cell tumors tend to recur 2 to 3 years after the initial diagnosis.]
5. Metastatic recurrence is rare in Sertoli-Leydig cell tumors. [Recurrence is usually confined to the pelvis and abdomen and without the presence of distant metastases.]



From the manuscript:
Ovarian Sertoli-Leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review
Radiology Case. 2014 Nov; 8(11):30-41


This article belongs to the OB/GYN section.




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From the manuscript

Ovarian Sertoli-Leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review

Free full text article: Ovarian Sertoli-Leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review

Abstract
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.






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