Sertoli-Leydig cell tumor of the ovary: a case report with endocrinologic observations

To present a case of a Sertoli-Leydig cell ovarian tumor and discuss the endocrinologic findings.

We describe the clinical manifestations in a female patient with an ovarian tumor and summarize the results of hormonal studies.

A 33-year-old woman with abrupt cessation of menses, progressive hirsutism, and weight gain because of a unilateral ovarian mass identified sonographically and an increased serum testosterone level underwent laparotomy, which disclosed a left ovarian Sertoli-Leydig cell tumor. Hysterectomy and bilateral adnexectomy were performed. Tissue extraction studies revealed 17-hydroxyprogesterone as the predominant steroid in tumor tissue in conjunction with substantially increased testosterone, free testosterone, dihydrotestosterone, androstenedione, and dehydroepiandrosterone levels and left ovarian vein effluent.

A unilateral ovarian mass associated with substantially increased serum testosterone should suggest the presence of a functioning ovarian tumor. Androgenic symptoms are a consequence of disturbed steroidogenesis from multipotential steroidogenic cells of ovarian stromal origin whose clinical effects depend on enzymatic specificity and the relative concentrations of steroids produced.