Abstract:

The medium-low differentiation Sertoli-Leydig cell tumor (SLCT) has the tendency to become a malignant tumor. A case of SLCT in an 18-year-old young woman was reported. Amenorrhea was the first symptom. Within then 10 months, she gradually developed defeminizing symptoms of breast atrophy, as well as signs of virilization such as protruding Adam′s apple, growth of lip beard, deep voice, and clitoral hypertrophy. She had a medical history of thyroid nodule surgery 6 years ago, and the function of thyroid was normal. A large cystic-solid tumor of the left ovary was found under the laparotomic exploration, approximately 10 cm in diameter. Operation was performed, including left adnexectomy, right ovary biopsy, bilateral para-colonic sulcus peritoneal biopsy and greater omentum biopsy. The postoperative pathological diagnosis indicated the medium-low differentiation of SLCT. The patient subsequently recovered well after 4 cycles of chemotherapy with paclitaxel liposome and carboplatin, and was successful childbirth. For women of childbearing age who exhibit de feminization or even masculinization, the possibility of ovarian SLCT should be considered. Fertility preserving surgery and radical surgery should be individualized according to the tumor grading. Patients with high risk of postoperative recurrence should receive timely chemotherapy to reduce the risk of secondary surgery and death.

Key words: Sertoli-Leydig cell tumor, Ovarian neoplasms, Virilism, Antineoplastic combined chemotherapy protocols, Fertility preservation