Bilateral ovarian cystic teratomas with a left Sertoli Leydig cell tumor: A case report

Ovarian mature cystic teratoma (MCT) is the most common ovarian germ cell tumor, and it is typically unilateral, although bilateral MCTs have been observed. Sertoli Leydig cell tumors (SLCTs) are rare ovarian tumors that can cause hyperandrogenemia. When patients have these 2 tumors at the same time, it is highly challenging to diagnose them.

A 32-year-old female patient who complained of a pelvic mass for 1 year and amenorrhea for 6 months with high testosterone and 17-hydroxyprogesterone levels was suspected of having a malignant ovarian tumor. Transvaginal ultrasound revealed mixed lesions in the bilateral adnexal areas, and the nature of the left slightly hyperechoic mass was not determined.

On the basis of the patient's laboratory examination, imaging examination and pathological examination, she was diagnosed with hyperandrogenemia and bilateral MCTs with a left SLCT.

The patient underwent laparoscopic surgery to remove bilateral ovarian neoplasms.

Testosterone levels decreased to 1.51 nmol/L on the 1st day after fertility-sparing bilateral ovarian tumor resection and to 0.73 nmol/L on the 5th day.

In conclusion, we reported a case of bilateral MCTs with left SLCT. The patient examinations supported the diagnosis of this rare disease. Once ovarian SLCT is diagnosed, the tumor should be surgically removed immediately, and the subsequent treatment plan should be selected according to the immunohistochemical results.