Sertoli-Leydig cell tumor of the ovary: a clinicopathologic study of 10 cases

Ten patients with Sertoli-Leydig cell tumors of the ovary treated consecutively were analyzed retrospectively for clinicopathological characteristics, treatment modalities and survival. All patients were subjected to a surgical procedure including unilateral salpingoophorectomy (USO) in 5, total abdominal hysterectomy, bilateral salpingoophorectomy (TAH+BSO) in 2, TAH+BSO and omentectomy and pelvic and paraaortic lymphadenectomy and appendicectomy in 3 patients. Following surgery, 5 patients were subjected to adjuvant VAC (vincristine+actinomycine-D+cyclophosphamide) chemotherapy. Sertoli-Leydig cell tumors constitued 0.6% of all ovarian neoplasms in our institution (10/1621). The mean age at diagnosis was 28.2 years. Of the patients, 8 had stage IA, one had IB and one had stage III disease at surgery. Bilaterality was observed in two patients (20.0%). Four patients had poorly-differentiated tumors, of whom 1 had a retiform pattern and 1 had a heterologue element, with marked mitosis whereas the others had well--or moderately--differentiated tumors. Only one patient presented with recurrence during pregnancy and died 16 months after initial surgery. Since most of the patients present with stage IA disease, a favorable outcome can be achieved in most of them and conservative surgery seems to be the treatment of choice in younger patients. However, late recurrences even in early stages, especially in patients with poorly-differentiated tumors, can be detected, resulting in a fatal outcome despite any form of aggressive therapy.