Sun Xichun, Hawkins Hal, Castro Claudia Y, Eltorky Mahmoud A
Department of Pathology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0588, USA.
Exp Mol Pathol. 2007 Feb;82(1):63-7. doi: 10.1016/j.yexmp.2006.08.001. Epub 2006 Oct 4.
Ovarian Sertoli-Leydig cell tumors (SLCT) are rare in young women. They are divided into six categories based on the degree of differentiation and the presence of heterologous elements. Less than 15% of these tumors are poorly differentiated. A 14-year-old obese African-American girl presented with amenorrhea, progressive abdominal pain, and increasing abdominal girth. Pelvic CT revealed a 10 x 9 x 9 cm right adnexal mass which was resected successfully. The gross appearance was dark tan and red with central hemorrhage and necrosis. Microscopically, this was poorly differentiated with compact aggregates of moderate size oval to elongated cells separated by zones of edematous stroma containing scattered spindle shape cells. Areas of ill-formed tubules and primitive cords were present. Clusters of Leydig cells were observed. The oval and spindle cells showed multiple mitoses and were diffusely positive for inhibin and patchy but strong positivity for calretinin. Both preoperative and postoperative studies revealed no metastases. Serum alpha-fetal protein (AFP), androgen, and dihydroepiandrosterone sulfate (DHEA-S) were elevated.
卵巢支持-间质细胞瘤（SLCT）在年轻女性中较为罕见。根据分化程度和异源性成分的存在情况，它们可分为六类。这些肿瘤中不到15%为低分化。一名14岁肥胖的非裔美国女孩出现闭经、进行性腹痛和腹围增加。盆腔CT显示右侧附件区有一个10×9×9cm的肿块，该肿块被成功切除。大体外观为深褐色和红色，伴有中央出血和坏死。显微镜下，该肿瘤为低分化，中等大小的椭圆形至细长形细胞紧密聚集，其间为含有散在梭形细胞的水肿性间质区。存在发育不良的小管和原始条索区域。观察到了Leydig细胞簇。椭圆形和梭形细胞显示多个有丝分裂，抑制素弥漫性阳性，钙视网膜蛋白呈散在但强阳性。术前和术后检查均未发现转移。血清甲胎蛋白（AFP）、雄激素和硫酸脱氢表雄酮（DHEA-S）升高。
