Abstract:Objective: To improve the diagnosis accuracy of ovarian sertoli-leydig cell tumor(SLCT), by exploring the MRI features. Materials and Methods: The MR images and clinicopathological characteristics were analysed in five cases with SLCT verified by surgery and pathology retrospectively. Results: The ages of the five cases ranged from 26 to 64 years old, three presenting signs of defeminization such as menstrual irregularities, amenorrhea and infertility, one presenting signs of masculinization such as hirsutism, acne and clitoromegaly, one complainting postmenopausal vaginal bleeding, and four cases with abdominal mass. The secrum testosterone was increased in all 5 cases. On MR, all 5 cases were unilateral with 2 in the right and 3 in the left. Four lesions were solid of round or oval shape with tiny cysts in 2 lesions. The solid components were hypointense on T1WI and slightly hyperintense on T2WI, hyperintense on DWI and hypointense on apparent diffusion coefficient map. The time signal intensity curve(TIC) of the solid regions showed sharp peak-plat form in dynamic contrast enhanced(DCE) MR imaging. One tumor was lobulated with multilobular cyst and nodular solid portion. The cyst was hypointense on T1WI and hyperintense on T2WI, while the solid part was hypointense on T1WI, slightly hyperintense on T2WI, and hyperintense on DWI. On histopathology, three SLCT cases were well differentiated, one was moderately differentiated and one was poorly differentiated. Immunohistochemically, all 5 cases were positive with inhibin and vimentin, and negative with epithelial membrane antigen(EMA). Conclusion: Ovarian SLCT demonstrates some characteristics on MR imaging, which will improve diagnosis accuracy combined with clinical features, and the final diagnosis usually depends on pathology.
方如旗,周作福,陈霞平,马 宏,潘地铃. 卵巢支持-间质细胞瘤的MR表现与临床病理对照分析[J]. 中国临床医学影像杂志, 2017, 28(7): 516-520.
FANG Ru-qi, ZHOU Zuo-fu, CHEN Xia-ping, MA Hong, PAN Di-ling. Analysis of MR imaging and clinicopathological characteristics of ovarian sertoli-leydig cell tumor. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(7): 516-520.
[1]Nouriani M, Felix C, Dubeau L. Histogenesis and histopathological characteristics of Sertoli-Leydig cell tumors[J]. CME J Gynecol Oncol, 2007, 7(2): 114-120.
[2]Zhang HY, Zhu JE, Huang W, et al. Clinicopathologic features of ovarian Sertoli-Leydig cell tumors[J]. Int J Clin Exp Pathol, 2014, 7(10): 6956-6964.
[3]Zanotti KM. The clinical manifestations and diagnosis of Sertoli-Leydig cell tumors of the ovary[J]. CME J Gynecol Oncol, 2002, 7(2): 129-133.
[4]Weng CS, Chen MY, Wang TY, et al. Sertoli-Leydig cell tumors of the ovary: a Taiwanese gynecologic oncology group study[J]. Taiwan J Obstet Gynecol, 2013, 52(1): 66-70.
[5]Moghazy D, Sharan C, Nair M, et al. Sertoli-Leydig cell tumor with unique nail findings in a post-menopausal woman: a case report and literature review[J]. J Ovarian Res, 2014, 7(2): 83-91.
[6]Kanade US, Dantkale SS, Narkhede RR, et al. Sertoli-leydig cell tumor of ovary with menorrhagia: a rare case report[J]. J Clin Diagn Res, 2014, 8(10): 18-20.
[7]De Oliveira Franzin CM, Kraft ML, Faundes D, et al. Detection of ovarian Sertoli-Leydig cell tumors exclusively by color Doppler sonography[J]. J Ultrasound Med, 2006, 25(10): 1327-1330.
[8]Abu-Zaid A, Azzam AZ, Alghuneim LA, et al. Poorly diff-erentiated ovarian sertoli-leydig cell tumor in a 16-year-old single woman: a case report and literature review[J]. Case Rep Obstet Gynecol, 2013, 2013: 858501.
[9]Cai SQ, Zhao SH, Qiang JW, et al. Ovarian Sertoli-Leydig cell tumors: MRI findings and pathological correlation[J]. J Ovarian Res, 2013, 6(1): 73-78.
[10]Tyagi R, Agrawal P, Nijhawan R, et al. Bilateral sertoli-leydig cell tumor in a primigravida: a rare case[J]. Rare Tumors, 2014, 6(2): 5408.
[11]Azuma A, Koyama T, Mikami Y, et al. A case of Sertoli-Leydig cell tumor of the ovary with a multilocular cystic appearance on CT and MR imaging[J]. Pediatr Radiol, 2008, 38(8): 898-901.
[12]方如旗,曹代荣,翁淑萍,等. 卵巢交界性浆液性、黏液性囊腺瘤的MRI表现及对比分析[J]. 临床放射学杂志,2014,9(33):1391-1394.
[13]方如旗,曹代荣,翁淑萍,等. 磁共振动态增强及扩散加权成像对复杂性卵巢肿瘤定性诊断的价值[J]. 临床放射学杂志,2014,11(33):1705-1709.
[14]Rathi M, Budania SK, Khalid M, et al. Bilateral retiform variant of sertoli leydig cell tumor of ovary: an uncommon tumor with review of literature[J]. J Mid Health, 2015, 6(1): 35-38.
[15]Horta M, Cunha TM, Marques RC, et al. Ovarian Sertoli-Leydig cell tumor with heterologous elements of gastrointestinal type associated with elevated serum alpha-fetoprotein level: an unusual case and literature review[J]. J Radiol Case Rep, 2014, 8(11): 30-41.