卵巢恶性 Sertoli-Leydig 细胞肿瘤经选择性卵巢静脉采样定位。

Malignant ovarian Sertoli-Leydig cell tumor localized with selective ovarian vein sampling.

机构信息

Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

J Minim Invasive Gynecol. 2012 Nov-Dec;19(6):789-93. doi: 10.1016/j.jmig.2012.08.006.

DOI:10.1016/j.jmig.2012.08.006

Abstract

Sertoli-Leydig cell tumors (SLCT) are rare, comprising less than 0.5% of ovarian neoplasms. They are most often diagnosed in premenopausal women and may produce androgens, resulting in hirsuitism, voice deepening, frontal balding, terminal hair growth, and clitoromegaly. SLCT are malignant in 15%-20% of cases. We discuss a 25-year-old patient with persistent hyperandrogenemia. Noninvasive imaging cannot conclusively differentiate between SCLT and other diagnoses such as polycystic ovary syndrome, ovarian hyperthecosis, idiopathic hyperandrogenism, idiopathic hirsuitism, and 21-hydroxylase-deficient nonclassic adrenal hyperplasia. Selective ovarian vein sampling revealed a 15-fold greater testosterone production from the right ovary compared with the left, which guided appropriate surgical management.

摘要

支持细胞瘤-间质细胞瘤（Sertoli-Leydig cell tumors，SLCT）较为罕见，占卵巢肿瘤的比例不足 0.5%。此类肿瘤多见于绝经前女性，可分泌雄激素，导致多毛症、声音变深沉、额部秃发、终毛生长和阴蒂肥大。15%-20%的 SLCT 为恶性肿瘤。我们讨论了一位 25 岁持续性高雄激素血症患者的诊治经过。非侵入性影像学检查无法明确区分 SLCT 和其他诊断，如多囊卵巢综合征、卵巢性索间质增生症、特发性高雄激素血症、特发性多毛症和 21-羟化酶缺乏型非经典肾上腺增生症。选择性卵巢静脉取血术显示右侧卵巢比左侧卵巢的睾酮生成增加了 15 倍，这有助于指导恰当的手术治疗。