Moghazy Dalia, Sharan Chakradhari, Nair Malika, Rackauskas Cassandra, Burnette Robert, Diamond Michael, Al-Hendy Omar, Al-Hendy Ayman
J Ovarian Res. 2014 Aug 28;7:83. doi: 10.1186/s13048-014-0083-5.
Sertoli-Leydig cell tumor (SLCT) is a rare sex-cord tumor that usually occurs unilaterally and accounts for < 0.5% of all ovarian tumors. SLCT is uncommon in post-menopausal women, with the average age of diagnosis being 25 years.
We present a case of a 63-year-old post-menopausal woman presenting with progressive hirsutism, and male-pattern baldness. Unusual nail changes were also observed.
Hormonal profile of the patient revealed increased testosterone and estradiol levels, and a 3.5 cm left ovarian mass. The patient was evaluated and was not found to be anemic or iron-deficient. Intraoperative frozen section assessment during laparoscopic exploration revealed SLCT, which was confirmed subsequently by histopathological and immunohistochemical (IHC) examination. Nail bed tissues were collected from normal females and evaluated by IHC for the presence of androgen receptors (AR).
The patient had an excellent postoperative course and all her testosterone-related manifestations were reversed within one year of surgery. Following surgery, the patient's unique nail abnormalities also resolved gradually. The IHC evaluation also confirmed the presence of AR in nail bed tissues of females.
SLCT, albeit rare, should be considered in post-menopausal women presenting with virilization and elevated androgen levels. Unusual nail signs may develop in response to increased androgen levels in these patients.
支持-间质细胞瘤（SLCT）是一种罕见的性索肿瘤，通常单侧发生，占所有卵巢肿瘤的比例小于0.5%。SLCT在绝经后女性中并不常见，诊断时的平均年龄为25岁。
我们报告一例63岁绝经后女性病例，该患者表现为进行性多毛症和男性型脱发。还观察到异常的指甲变化。
患者的激素水平显示睾酮和雌二醇水平升高，左侧卵巢有一个3.5厘米的肿块。对患者进行评估，未发现贫血或缺铁。腹腔镜探查术中冰冻切片评估显示为SLCT，随后经组织病理学和免疫组织化学（IHC）检查证实。从正常女性收集甲床组织，通过IHC评估雄激素受体（AR）的存在情况。
患者术后恢复良好，术后一年内所有与睾酮相关的表现均得到逆转。手术后，患者独特的指甲异常也逐渐消失。IHC评估还证实女性甲床组织中存在AR。
对于出现男性化和雄激素水平升高的绝经后女性，尽管SLCT罕见，但仍应考虑该病。这些患者可能会因雄激素水平升高而出现异常的指甲体征。
