Background: Sertoli-Leydig cell tumors (SLCTs), also known as arrhenoblastomas, are tumors of the sex cord-stromal group of ovary and testis cancers. They comprise <1% of all ovarian tumors. They are divided into 6 categories based on the degree of differentiation and the presence of heterologous elements. However, <15% of these tumors are poorly differentiated. Case: A 23-year-old unmarried female presented with an 8-month history of irregular menstrual cycle and abdominal pain. There were no clinical features suggesting virilization. The left salpingo-oophorectomy specimen revealed an oval ovarian mass of 11 × 7 × 4 cm in dimension. Grossly, the cut surface of the mass was yellowish white in color and solid in consistency and touch preparation was made. By applying cytology and immunocytochemistry techniques, a preliminary diagnosis suggestive of poorly differentiated SLCT was made. The tumor was confirmed as a poorly differentiated SLCT. Conclusion: Cytology and immunocytochemistry by WT-1, melan A, vimentin and calretinin are helpful in the diagnosis of poorly differentiated SLCTs.

Keywords:
Cytology, Immunocytochemistry, Immunohistochemistry, Ovarian stromal tumors, Sertoli-Leydig cell tumor
1.
Tavassoli FA, Devilee P: World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Breast and Female Genital Organs, ed 3. Lyon, IARC Press, 2003, pp 146–160.
2.
Young RH, Scully RE: Ovarian Sertoli-Leydig cell tumors: a clinicopathological analysis of 207 cases. Am J Surg Pathol 1985;9:543–569.
3.
Ramzy I: Gonads and miscellaneous deep organ; in Ramzy I: Clinical Cytopathology and Aspiration Biopsy, ed 2. New York, McGraw-Hill, 2001, pp 527.
4.
Guo M, Lim JC, Wojcik EM: Pelvic washing cytology of ovarian Sertoli-Leydig-cell tumor with retiform pattern: a case report. Diagn Cytopathol 2003;29:28–30.
5.
Daneshbod Y, Khademi B, Kadivar M, Ganjei-Azar P: Fine needle aspiration of salivary gland lesions with multinucleated giant cells. Acta Cytol 2008;52:671–680.
6.
Koonings PP, Campbell K, Mishell DR Jr, Grimes DA: Relative frequency of primary ovarian neoplasm: a 10-year review. Obstet Gynecol 1989;74:921.
7.
Young RH, Scully RE: Ovarian Sertoli-Leydig cell tumors: a clinicopathological analysis of 207 cases. Am J Surg Pathol 1985;9:543–569.
8.
Young RH, Scully RE: Sex cord-stromal, steroid cell and other ovarian tumors; in Kurman RJ (ed): Blaustein’s Pathology of the Female Genital Tract, ed 5. New York, Springer, 2002, pp 929–939.
9.
Young RH, Scully RE: Ovarian Sertoli-Leydig cell tumors with retiform pattern: a problem in histopathologic diagnosis. A report of 25 cases. Am J Surg Pathol 1983;7:755–771.
10.
Kronz JD, Nicol TL, Rosenthal DL, Ali SZ: Metastatic testicular Sertoli-cell tumor: cytopathologic findings on fine-needle aspiration. Diagn Cytopathol 1998;19:127–130.
11.
Terayama K, Hirokawa M, Shimizu M, Kanahara T, Manabe T: Sertoli cell tumor of the testis. Report of a case with imprint cytology findings. Acta Cytol 1998;42:1458–1460.
12.
Mandurino S, Mazzei C: A case of ovarian arrhenoblastoma. Arch Sci Med 1982;139:139–142.
13.
Zhao C, Vinh TN, McManus K, Dabbs D, Barner R, Vang R: Identification of the most sensitive and robust immunohistochemical markers in different categories of ovarian sex cord-stromal tumors. Am J Surg Pathol 2009;33:354–366.
14.
Zhao C, Barner R, Vinh TN, McManus K, Dabbs D, Vang R: SF-1 is a diagnostically useful immunohistochemical marker and comparable to other sex cord-stromal tumor markers for the differential diagnosis of ovarian Sertoli cell tumor. Int J Gynecol Pathol 2008;27:507–514.
15.
Ohashi M, Hasegawa Y, Haji M, Igarashi M, Nawata H: Production of immunoreactive inhibin by a virilizing ovarian tumour (Sertoli-Leydig tumour). Clin Endocrinol 1990;33:613–618.
16.
Busam KJ, Iversen K, Coplan KA, Old LJ, Stockert E, Chen YT, McGregor D, Jungbluth A: Immunoreactivity for A103, an antibody to melan-A (Mart-1), in adrenocortical and other steroid tumors. Am J Surg Pathol 1998;22:57–63.
17.
Zheng W, Senturk BZ, Parkash V: Inhibin immunohistochemical staining: a practical approach for the surgical pathologist in the diagnosis of ovarian sex cord-stromal tumors. Adv Anat Pathol 2003;10:27–38.
18.
Movahedi-Lankarani S, Kurman RJ: Calretinin, a more sensitive but less specific marker than alpha-inhibin for ovarian sex cord-stromal neoplasms. Am J Surg Pathol 2002;26:1477–1483.
19.
Benjamin E, Law S, Bobrow LG: Intermediate filaments cytokeratin and vimentin in ovarian sex cord-stromal tumours with correlative studies in adult and fetal ovaries. J Pathol 1987;152:253–263.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.