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Ovarian Sertoli-Leydig cell tumor with elevated serum alpha-fetoprotein
I Motoyama1, H Watanabe, A Gotoh
1Department of Pathology, Niigata University School of Medicine, Japan.
Cancer
|May 15, 1989
Summary
A rare ovarian Sertoli-Leydig cell tumor (SLCT) in an 18-year-old girl produced alpha-fetoprotein (AFP). This tumor-derived AFP differed from that typically found in the liver.
Area of Science:
- Gynecologic Oncology
- Endocrinology
- Pathology
Background:
- Sertoli-Leydig cell tumors (SLCTs) are rare ovarian neoplasms. Virilization in young women can indicate an androgen-secreting tumor.
- Elevated serum alpha-fetoprotein (AFP) is typically associated with germ cell tumors, but can occur in other ovarian neoplasms.
Observation:
- An 18-year-old female presented with virilization and elevated serum AFP.
- Imaging revealed an ovarian mass consistent with SLCT.
- Histopathology showed a mixed SLCT with heterologous gastrointestinal epithelium, retiform pattern, and Sertoli-like cells.
Findings:
- Immunohistochemistry confirmed AFP production by Sertoli-like cells within the tumor.
- Leydig cells within the tumor produced testosterone, correlating with virilization.
- Lectin affinity chromatography demonstrated that tumor-derived AFP differed from hepatic AFP.
Implications:
- This case highlights that SLCTs can produce AFP, expanding the differential diagnosis for AFP elevation in young women.
- The distinct biochemical profile of tumor-derived AFP suggests unique glycosylation patterns.
- Understanding the source and characteristics of tumor markers is crucial for accurate diagnosis and management of ovarian neoplasms.