Retiform Sertoli-Leydig cell tumour of the ovary

Epidemiology

This is a rare variant of Sertoli-Leydig cell tumour of the ovary. It presents at a relatively young age and has a lower incidence of virilisation.

Macroscopic appearances

These tumours are variably solid and cystic with spongy haemorrhagic areas.

Histopathology

The various components consist of:

Immunohistochemistry, based on 19 cases1:

 

Stroma

Retiform areas

Sex cord component

Leydig cells (present in 9 of 19 cases)

 

cytokeratin cocktail

moderate positivity

intense positivity

moderate positivity

negative

inhibin

moderate positivity

weak positivity

moderate positivity

intense positivity

vimentin

moderate to intense positivity

weak to moderate positivity

intense positivity

intense positivity

EMA

negative

weak positivity in one case

negative

negative

CD99

negative

negative

negative

negative

ER

negative

negative

moderate positivity

negative

PR

negative

moderate to intense positivity

moderate positivity

negative

 

Hepatocytes, resembling Leydig cells, were demonstrated in 5 of 8 cases and showed weak inhibin positivity as well as cytokeratin and AFP positivity. One case showed mucinous heterologous epithelium, which was moderately positive for inhibin.

Differential diagnosis

Prognosis

About 25% of cases show malignant behaviour. Mesenchymal heterologous elements are an indicator of malignancy.

References

1Mooney, E. E., Nogales, F. F., Bergeron, C., Tavassoli, F. A. Retiform Sertoli-Leydig cell tumours: clinical, morphological and immunohistochemical findings. Histopathology 2002;41:110-117.

This page last revised 4.12.2002.

©SMUHT/PW Bishop