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

Authors

  • Mariana Horta
  • Teresa Margarida Cunha
  • Rita Canas Marques
  • Ana Félix

DOI:

https://doi.org/10.3941/jrcr.v8i11.2272

Keywords:

Sertoli-Leydig tumor, Alpha-fetoprotein, Sex cord-stromal tumor, Ovarian tumor, Ultrasound, Magnetic resonance

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.

Author Biographies

Mariana Horta

M.D. 

Servií§o de Radiologia. Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.

Instituto de Anatomia. Faculdade de Medicina da Universidade de Lisboa.

Teresa Margarida Cunha

M.D.

Servií§o de Radiologia. Instituto Portuguíªs de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal     

 

Rita Canas Marques

M.D.

Servií§o de Anatomia Patológica.Instituto Portuguíªs de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal

Ana Félix

PhD

Servií§o de Anatomia Patológica.Instituto Portuguíªs de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal

Published

2014-11-24

Issue

Section

Obstetric & Gynecologic Radiology