Fertility Preservation and Spontaneous Pregnancy in a Young Woman with Sertoli-Leydig Cell Tumor: A Five-Year...

Sertoli-Leydig cell tumors (SLCTs) are uncommon ovarian sex cord-stromal neoplasms that predominantly affect young women and are frequently associated with hyperandrogenic features.

A 23-year-old nulliparous woman presented with a left ovarian mass, accompanied by amenorrhea, clinical signs of virilization, and significantly elevated α-fetoprotein levels. Surgical intervention via left salpingo-oophorectomy was performed. Histopathological evaluation confirmed a Stage IA moderately to poorly differentiated SLCT. Postoperative management included adjuvant chemotherapy with the etoposide and cisplatin, along with administration of a gonadotropin-releasing hormone agonist as an adjunctive measure. No evidence of tumor recurrence was observed over a five-year surveillance period. Subsequently, the patient achieved a spontaneous pregnancy and delivered a healthy male neonate via vaginal delivery.

This case demonstrates that in young women with stage IA SLCT, fertility-sparing surgery combined with adjuvant chemotherapy and ovarian preservation strategies may be considered feasible in selected patients for five-year disease-free survival and subsequent spontaneous pregnancy.