Incidental finding of a Sertoli-Leydig cell tumor in a postmenopausal woman with complex endometrial hyperplasia




Postmenopausal bleeding, Sertoli-Leydig cell tumor, Sex cord stromal tumor


Sertoli-Leydig cell tumors (SLCTs) arise from the non-germ cell component of the ovary and typically present in young women with evidence of hyperandrogenism such as precocious puberty, amenorrhea, hirsutism and virilization. It is very rare accounting for less than 0.2% of all ovarian tumors, and because of the rarity, no standardized treatment approach has reached a consensus. The prognosis is generally good with complete reversion of symptoms after surgery, although some cases have been reported to be malignant. Recently the need for DICER1 mutations testing in paediatric patients has been emphasized for the surveillance of possible synchronous tumors and affected family members. Authors present here a case of Sertoli-Leydig cell tumor incidentally found while performing a hysterectomy with bilateral salpingo-oophorectomy in a postmenopausal woman with endometrial hyperplasia that caused intractable vaginal bleeding.


Schultz KA, Harris AK, Schneider DT. Ovarian sex cord-stromal tumor. Oncol Pract. 2016;12:940.

Souto SB, Baptista PV, Braga DC. Ovarian Leydig cell tumor in a post-menopausal patient with severe hyperandrogenism. Arq Bras Endocrinol Metab. 2014;58:68-70.

Swain J, Sharma S, Prakash V. Steroid cell tumor: a rare cause of hirsutism in a female. Endocrinol Diabetes Metab Case Rep. 2013;2013:130030.

Luke AM, Moroney JW, Snitchler A, Whiteway SL. Ovarian Sertoli-Leydig cell tumor with elevated inhibin B as a cause of secondary amenorrhea in an adolescent with germ line DICER1 mutation. J Pediatr Adolesc Gynecol. 2017;30:598-600.

Koeneman MM, Heiligers-Duckers C, van der Velde R, Wouda S, Rooij MJM, Boskamp D. Ovarian Leydig cell hyperplasia as a rare cause of hair loss in a postmenopausal female patient: a case report and diagnostic approach toward postmenopausal hyperandrogenism. European J Obstet Reprod Biol. 2016;199:198-200.

Litta P, Saccardi C, Conte L, Codroma A, Angioni S, Mioni R. Sertoli-Leydig cell tumors: current status of surgical management: literature review and proposal of treatment. Gynecol Endocrinol. 2013;29:412-7.

Nam SM, Kim JW, Eoh KJ, Kim HM, Lee JY, Nam EJ, et al. A novel clinicopathological analysis of early stage ovarian Sertoli-Leydig cell tumors at a single institution. Obstet Gynecol Sci. 2017;60(1):39-45.

Palha A, Cortez L, Tavares AP, Agapito A. Leydig cell tumor and mature ovarian teratoma: rare androgen-secreting ovarian tumors in postmenopausal women. BMJ Case Rep. 2016;2016:bcr2016215985.

Moghazy D, Sharan C, Nair M. Sertoli-Leydig cell tumor with unique nail findings in a postmenopausal woman: a case report and literature review. J Ovarian Res. 2014;7:83-7.

Shaw NM, Stauffer C, Eisenberg ML. Leydig cell tumor found incidentally during microscopic testicular sperm extraction in patient with mosaic Klinefelter syndrome: case report. Fertil Steril. 2016;106:1344-7.

Walker J, Powell B, Chen LM, Carter J, Bae Jump V, Gibb R, et al. Society of gynecologic oncology recommendations for the prevention of ovarian cancer. Cancer. 2015;121:2108-20.

Perez-Lopez F, Ceausu I, Depypere H, Kehoe S, Lambrinoudaki I, Rees M, et al. Interventions to reduce the risk of ovarian and fallopian tube cancer: a European menopause and andropause society position statement. Maturitas. 2017;100:86-91.

Chen L, Tunnell C, De Petris G. Sertoli-Leydig cell tumor with heterologous element: a case report and a review of the literature. Int J Clin Exp Pathol. 2014;7:1176-81.

Zhao C, Vinh TN, McManus K, Dabbs D, Barner R, Vang R. Identification of the most sensitive and robuts immunohistochemical markers in different categories of ovarian sex cord-stromal tumors. Am J Surg Pathol. 2009;33:354-66.






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