Sertoli–Leydig cell tumour

Sertoli–Leydig cell tumour, also known as androblastoma, is a rare type of ovarian cancer that involves both the Sertoli cells, which are part of the seminiferous tubules in the testes, and the Leydig cells, which are found in the testicular interstitium. These tumors are part of a group of neoplasms referred to as sex cord-stromal tumors of the ovary. They account for less than 0.5% of all ovarian tumors. Sertoli–Leydig cell tumors are most commonly found in young women, typically presenting in the second and third decades of life.

Symptoms and Signs

The clinical presentation of Sertoli–Leydig cell tumors can vary significantly but often includes signs and symptoms of virilization due to the production of male sex hormones, primarily testosterone. These symptoms may include hirsutism, amenorrhea, a deepened voice, and clitoromegaly. Other possible symptoms include abdominal pain or a palpable mass in the abdomen, which could indicate the presence of a tumor.

Diagnosis

Diagnosis of Sertoli–Leydig cell tumors typically involves a combination of physical examination, ultrasound imaging of the pelvis, and blood tests to measure hormone levels. Elevated levels of testosterone or other androgens may suggest the presence of these tumors. In some cases, a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used to further evaluate the tumor's size and spread. Definitive diagnosis is usually achieved through surgical resection and histopathological examination of the tumor tissue.

Treatment

The primary treatment for Sertoli–Leydig cell tumors is surgical removal of the tumor. This may involve oophorectomy (removal of one ovary) or bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes), depending on the extent of the disease and the patient's desire to preserve fertility. In advanced cases, additional treatments such as chemotherapy or radiation therapy may be considered. The choice of treatment depends on the stage of the tumor, its histological features, and the patient's overall health and reproductive goals.

Prognosis

The prognosis for patients with Sertoli–Leydig cell tumors is generally favorable, especially for those with tumors confined to the ovary and with low-grade histology. The overall 5-year survival rate is high, but recurrence can occur, necessitating long-term follow-up.

Epidemiology

Sertoli–Leydig cell tumors are rare, accounting for less than 0.5% of all ovarian tumors. They are most commonly diagnosed in young women, with a peak incidence in the second and third decades of life.

See Also

• Ovarian cancer
• Sex cord-stromal tumor
• Virilization
• Oophorectomy