Poorly differentiated Sertoli–Leydig tumor with heterologous
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Sex-cord stromal tumors arise from the ovarian stroma that surrounds and supports the oocytes. They are relatively rare among ovarian neoplasms, accounting for only 1.2% of ovarian tumors. These ovarian cancers are generally expected to be low-grade, diagnosed at an early stage, and lymph node metastases are exceedingly rare. Sertoli–Leydig tumors, in particular, account for less than 0.5% of ovarian neoplasms. Sertoli–Leydig tumors are a subgroup of sex-cord stromal tumors, which tend more toward “male” differentiation, hence the term “androblastoma”. These tumors are comprised of cells normally found in the male gonads that produce androgens, often resulting in hirsutism and virilization in up to two-thirds of female patients. Sertoli–Leydig tumors are typically firm and solid, composed of tubules surrounded by fibrous stroma. Most commonly, patients present during the second and third decades, with an average size of 16 cm in diameter. This article reports the case of a 31-year-old female who developed a large pelvic mass with elevated tumor markers and an exceedingly rare histology...

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