Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
Gynecol Endocrinol. 2013 May;29(5):412-7. doi: 10.3109/09513590.2012.754878. Epub 2013 Feb 4.
To identify the appropriate management we review the current literature on the diagnostic and different surgical procedures to which the patients affected by Sertoli-Leyding cell tumors (SLCTs) were submitted. Through the description of a case report we also propose an interdisciplinary diagnostic approach and a laparoscopic surgical staging, with a long-term follow-up. The analysis shows that pelvic ultrasound is primary diagnostic procedure, and only 36% of publications clearly describe to have performed more specific investigation. The hormone assessment is performed in the presence of specific endocrine symptoms. Laparoscopic approach is chosen by a few surgeon. Laparotomic surgery is preferred based in not recent recommendations for ovarian cancer treatment, although it is demonstrated the efficacy and safety of laparoscopy in the treatment of ovarian epithelial tumors. Different steps that are usually used for oncological ovarian cancer staging are not always performed. Conservative and fertility sparing surgery is commonly accepted, and even preferred due to the young age of patients. In the surgical treatment of SLCTs is necessary to adopt common guidelines, and evenly define the steps that the patient should be submitted. If are observed epithelial cancer oncological principles, laparoscopic surgery should be the approach of choice for these patients.
为了确定适当的治疗方法,我们回顾了目前关于诊断和不同手术程序的文献,这些患者患有支持细胞-间质细胞瘤(SLCT)。通过描述一个病例报告,我们还提出了一种跨学科的诊断方法和腹腔镜手术分期,并进行了长期随访。分析表明,盆腔超声是主要的诊断程序,但只有 36%的出版物明确描述了进行了更具体的检查。激素评估是在存在特定内分泌症状的情况下进行的。只有少数外科医生选择腹腔镜方法。基于对卵巢癌治疗的非最新建议,选择开腹手术,尽管腹腔镜在治疗卵巢上皮性肿瘤方面已被证明是有效和安全的。并非总是进行通常用于卵巢癌分期的不同步骤。保留生育功能的保守手术是普遍接受的,甚至是首选,因为患者年龄较轻。在 SLCT 的手术治疗中,有必要采用通用指南,明确界定患者应接受的步骤。如果观察到上皮性癌的肿瘤学原则,那么腹腔镜手术应该是这些患者的首选方法。