Androgen‐Producing Ovarian Tumors: A Clinicopathological Study of 3 Cases

Abstract

The clinical course and pathological findings of 3 rare cases of androgen-producing ovarian tumors are presented. The ages of the 3 patients (Cases 1, 2, and 3, respectively) were 43, 34, and 57 years, respectively. Their preoperative serum testosterone levels were 506, 491, and 231 ng/dl, respectively. The pathological diagnoses of Cases 1, 2, and 3 were a Sertoli-stromal cell tumor of intermediate differentiation, a stromal tumor containing Leydig cells, and a stromal tumor with minor sex cord elements, respectively. Patient 1 experienced a recurrence, of a lesion at the vaginal stump 1 year and 2 months after the initial surgery. The clinical courses of Cases 2 and 3 have been non-contributory.

Extraovarian Fibroma With Minor Sex Cord Elements: A Case Report and Literature Review

“…To date, 17 cases have been reported in the English-language literature. 24-33 The major components of the tumor were fibroma (8 cases including the present case), fibrothecoma (3 cases), thecoma (1 case), Leydig cell tumor (3 cases), and others. The sex cord elements were composed of fully differentiated granulosa cells, undifferentiated sex cord–type cells, or tubular structures resembling immature Sertoli cells, and these elements occupied less than 10% of the total tumor area.…”

“…Estrogen production by these tumors is a risk factor for endometrial carcinoma. Increased serum estradiol or symptoms consistent with hormonal manifestations were observed in 42% (10/24 cases) of extraovarian SCST cases and in 50% (9/18 cases) of ovarian stromal tumors with minor sex cord elements, 1-33 and 22% (4/18 cases) of the latter cases were complicated by endometrial carcinoma. 25,29,32 It is noteworthy that even minor sex cord elements were associated with estrogen production and endometrial carcinogenesis in some cases.…”

“…The sex cord elements were composed of fully differentiated granulosa cells, undifferentiated sex cord–type cells, or tubular structures resembling immature Sertoli cells, and these elements occupied less than 10% of the total tumor area. 24-33 The elements showed overlapping immunoreactivities, and they were almost all positive for inhibin or calretinin. 28,29,31-33 In the present case, both types of sex cord elements were positive for inhibin and WT1, while only the undifferentiated sex cord–type elements were positive for calretinin, vimentin, and ER.…”

“…1-23 Furthermore, ovarian stromal tumor with minor sex cord elements is also a rare tumor that was first described by Young and Scully in 1982. 24-33 This tumor may pose a diagnostic dilemma on histological examination.…”