Sertoli cell tumour of the ovary

Definition

An ovarian tumour showing, at least in part, a tubular pattern, analogous to Sertoli cell tumour of the testis.

Epidemiology

Sertoli cell tumours account for only 4% of all Sertoli-stromal tumours of the ovary. Ovarian Sertoli cell tumours occur in both adults and children. Some cases are associated with Peutz-Jegher's syndrome.

Clinical features

Patients may show estrogenic or androgenic effects.

Macroscopic appearances

Tumours are unilateral, solid and usually yellow. There may be limited cystic degeneration.

Histopathology

The tumour cells form solid or hollow tubules, trabeculae, diffuse sheets, pseudopapillae or islands. The tumour cells usually have pale to eosinophilic cytoplasm but may be foamy (lipid-rich Sertoli cell tumour). Nuclei are typically round to oval with inconspicuous nucleoli. Nuclear grooves may be apparent. The stroma is often abundant and may be sclerotic.

Nuclear atypia and a mitotic rate greater than 5/10 HPF are associated with malignant behaviour.

Immunohistochemistry

	AE1/3-Cam5.2	15/23 (staining was strong in 13 cases)1
	EMA	0/231
	Inhibin	18/22 (staining was strong in 17 cases)1
	Calretinin	10/20 (in most cases, staining was weak)1
	CD99	19/221
	Vimentin	17/181
	SMA	4/181
	NSE	8/161
	S-100	2/201
	Chromogranin	0/211

Differential diagnosis

• Endometrioid carcinoma: inhibin negative, EMA positive. There are almost always areas of typical endometrioid carcinoma. Both endometrioid carcinoma and Sertoli cell tumour may have a predominance of spindle or oxyphilic cells.

• Carcinoid tumour: inhibin negative, EMA positive, chromogranin positive. The acini show brush borders. The stroma is typically more fibrotic.

• Sertoli-Leydig cell tumours: has more than rare Leydig cells, a retiform pattern and heterologous elements

• Adult granulosa cell tumour

• FATWO: more often found in the broad ligament but may occur in the ovary. Cysts and sieve-like areas are typically seen.

• Steroid cell tumour: lacks a tubular pattern.

• Struma ovarii: contain colloid and are associated with a dermoid cyst.

• Dysgerminoma: consists of diffuse tumour cells separated by fibrous septa

• Metastatic (Krukenberg) tumour

Prognosis

Most Sertoli cell tumours are confined to the ovary and show benign behaviour.

References

¹Oliva E, Alvarez T,Young RH Sertoli cell tumors of the ovary: a clinicopathologic and immunohistochemical study of 54 cases. Am J Surg Pathol 2005; 29:143-56

This page last revised 3.2.2005.

©SMUHT/PW Bishop