Cystic Sertoli-Leydig Cell Tumour in a Postmenopausal Woman with Absent Virilising Symptoms:
A Diagnostic Challenge
Published: May 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/26173.9901
Vidya Monappa, Saritha M Reddy, Ranjini Kudva, Muralidhar V Pai
1. Associate Professor, Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
2. Resident, Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
3. Professor, Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
4. Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Correspondence
Dr. Vidya Monappa,
Department of Pathology, Basic Science Block, KMC, Manipal, Karnataka, India.
E-mail: vidsdr@yahoo.co.in
A 60-year-old postmenopausal woman, presented with a left ovarian cystic mass with mildly elevated CA125 levels. An intraoperative frozen section showed oedematous ovarian stroma with interspersed large aggregates of spindle shaped stromal cells. Subsequently, the excised specimen was reported as Sertoli-Leydig Cell Tumour (SLCT) of intermediate differentiation. The leydig cells were identified in the imprint smears, but were misinterpreted as luteinized cells. The lack of tubular differentiated cells in frozen section had contributed to the misdiagnosis. Immunohistochemistry (IHC) played an important diagnostic role in the absence of clinical suspicion and lack of virilising features that are classically described in association with SLCTs. This case is unusual, as the tumour was seen in a postmenopausal woman in the absence of virilising symptoms. The cytomorphological features, IHC findings and the reasons for misdiagnosis are discussed in this case report.
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