Sertoli-Leydig cell tumor of the ovary: Radiologic-operative
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A 27-year-old woman visited the outpatient clinics due to persistent vaginal bleeding for one month. She had a history of thyroid cancer treated with total thyroidectomy with thyroxin treatment at 24 years of age. Transvaginal ultrasound (TVS) revealed a well-defined cystic mass lesion measured with 49 × 33 × 56 mm in size located on the vesicouterine space. Computed tomography (CT) showed a complex cystic lesion with an enhancing soft tissue part in favor of tumor growth of the left adnexa. Physical examination and laboratory data, including tumor markers all, revealed unremarkable findings. Then, the patient underwent laparoscopic surgery for the tumor. During operation, the tumor showed a well-defined mass with a yellow-stained and white-colored surface located on the vesicouterine space.

Since it is nearly impossible to enucleate the tumor and concern the possibility of tumor spillage, laparoscopic salpingo-oophorectomy was performed and removed through the umbilical port wound with endobag. Macroscopically, the tumor showed multiple dark-red nodules with a thick septum and bloody fluid within the ovary and microscopically, oval and spindle tumor cells in a nested and lobular pattern which were positive for alpha inhibin and calretinin staining but negative for INSM1 (insulinoma-associated protein 1) staining compatible with the diagnosis of SLCT. Postoperative recovery was uneventful. The patient received postoperative hormone suppression treatment by gonadotropin-releasing hormone agonist (GnRH agonist) for maintenance therapy.