Abstract：
Sertoli-Leydig Cell Tumors (SLCT) are very rare neoplasms of the ovary (0.2%) and they belong to the group of sex cord-stromal tumors. Of these, 20% of the cases show heterologous elements. We report a case of a 22-year-old woman who presented with complaints of lower abdominal pain and secondary amenorrhea for 10 months. Physical examination revealed right lower abdominal tenderness and fullness. Imaging showed a right ovarian mass. She underwent right salpingo-oophorectomy with bilateral pelvic lymphadenectomy and omentectomy. Microscopic examination revealed a neoplasm with varied histomorphological patterns. The predominant pattern was an atypical proliferative mucinous tumor with foci of microinvasion. The other component was that of moderately differentiated Sertoli-Leydig Cell Tumor. Focal areas resembling carcinoid were also noted. Immunohistochemistry was performed and the Sertoli-Leydig Cells were positive for CD56, calretinin, inhibin, vimentin, and ER. The glandular component was positive for CK20, EMA, CEA, and CDX2. Synaptophysin and chromogranin were positive within nests resembling carcinoid. With the given histomorphological features and immunohistochemistry findings, a diagnosis of moderately differentiated Sertoli-Leydig Cell Tumor of the ovary with associated mucinous carcinoma and carcinoid was rendered. The presence of heterologous elements in SLCTs has been reported to be associated with poor prognosis.
摘要：
睾丸支持-睾丸间质细胞肿瘤（SLCT）是非常罕见的卵巢肿瘤（0.2％），属于性索间质肿瘤。其中,20%的病例显示异源元件。我们报告了一例22岁的妇女，她抱怨下腹痛和继发性闭经10个月。体格检查显示右下腹压痛和饱胀。影像学显示右侧卵巢肿块。她接受了右输卵管卵巢切除术，双侧盆腔淋巴结清扫术和网膜切除术。显微镜检查显示肿瘤具有不同的组织形态学模式。主要模式是具有微侵袭灶的非典型增生性粘液性肿瘤。另一种成分是中等分化的睾丸支持-睾丸间质细胞肿瘤。还注意到类似类癌的焦点区域。进行免疫组织化学，Sertoli-Leydig细胞对CD56，钙视网膜素呈阳性，抑制素,波形蛋白,和ER。腺体成分CK20、EMA、CEA,CDX2。突触素和嗜铬粒蛋白在类似类癌的巢中呈阳性。根据给定的组织形态学特征和免疫组织化学结果，诊断为卵巢中分化Sertoli-Leydig细胞肿瘤并伴有粘液性癌和类癌。据报道，SLCTs中异源元件的存在与不良预后有关。
