Sertoli Leydig cell tumor with unusual tumor marker: management dilemmas
Sreelakshmi Kodandapani, Jayaram Nambiar, Vidya Kamath, Muralidhar V Pai and Lakshmi Rao
World Journal of Medical and Surgical Case Reports 2013, 2:12
Sertoli Leydig Cell tumors are rare sex-cord tumors. They cause virilization of female characterized by hirsuitism, temporal baldness, hoarseness of voice and clitoromegaly. Rarely they have heterologous cells and produce alpha fetoprotein (AFP). They cause raised serum alphafetoprotein which can be detected in tissue by immunohistochemistry.
We report an 18 year old girl who presented to us with hoarseness of voice, hirsuitism, pain abdomen and vomiting. Huge ovarian mass was diagnosed by ultrasound. She had very high serum alphafetoprotein levels. She underwent staging laparotomy with salpingo-oophorectomy. Histopathology was Sertoli Leydig Cell Tumor with hepatoid differentiation. Postoperatively she received chemotherapy. Serum alphafetoprotein was monitored and levels reduced, thus indicating response to treatment.
Incidence of Sex cord tumors per se is rare. Hepatoid differentiation of these tumors with production of alphafetoprotein is very rare. Although five similar cases are reported earlier, we believe addition of this case is useful. Detailed preoperative evaluation and histopathology were useful in this case management
Sertoli leydig cell tumor, alphafetoprotein hirsuitism, immunohistochemistry