Ovarian Sertoli-Leydig cell tumors: A single institution experience and review of the literature

Purpose of Investigation: Sertoli-Leydig cell tumors (SLCTs) of the ovary are rare, usually presenting as virilization in women in their second to third decade of life. Less than 10% of patients are older than age 50. The authors present a series of cases of SCLT managed at their institution. Materials and Methods: A retrospective review was performed of all cases of ovarian SLCT diagnosed at a tertiary care institution between 1990-2014. Demographic data, clinical presentation, pathological findings, and treatment modalities were collected. Results: Of the 16 patients diagnosed with SCLT over a 24-year period, nine patients (56%) were postmenopausal at the time of diagnosis, with a median age of 52.5 years (IQR = 39.7 years). These nine patients had a median interval of 14.7 years (IQR = 15) since the onset of menopause. Hyperandrogenism was a presenting feature in only five of 16 (31%) [median age of 49 (IQR= 26.5)] whereas postmenopausal bleeding was noted in two of 16 (12%). At diagnosis, tumor grade varied from well- to poorly-differentiated lesions, and eight patients (15%) received adjuvant chemotherapy. Disease-free survival over a median follow up of 31.5 months (IQR = 73.5 months) was 100% without recurrence. Conclusion: The present patient population was noticeably older than what has been described in literature, with the majority being postmenopausal. To the authors' knowledge, this is the largest series of postmenopausal patients with SLCT. Hyperandrogenism was evident in only a small sub-group. While the definitive management of SLCT remains controversial and varied, prognosis and risk of recurrence are reassuring.