Ovarian Sertoli-Leydig cell tumor with heterologous gastrointestinal epithelium as a source of alpha-fetoprotein: A case report

Takafumi Watanabe, Hidekazu Yamada, Yutaka Morimura, Masafumi Abe, Teiichi Motoyama, Akira Sato

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    14 Citations (Scopus)

    Abstract

    Ovarian Sertoli-Leydig cell tumors (SLCT) are rare sex cord stromal neoplasms. To date there have been approximately 25 case reports of ovarian SLCT expressing alpha-fetoprotein (AFP). In such cases, AFP was immunohistochemically detected in the Sertoli cells, Leydig cells, or hepatocytes. This case report confirms heterologous gastrointestinal epithelium expression of AFP. A 20-year-old woman presented with complaints of abdominal enlargement and irregular menstrual cycles over one year. A right ovarian tumor was detected and the patient's serum AFP was elevated. A right salpingo-oophorectomy was performed. On microscopic examination, the tumor was composed of a fibrosarcoma-like area and a poorly differentiated SLCT area with heterologous gastrointestinal epithelium. Immunohistochemical analysis detected AFP in the gastrointestinal epithelium only. Postoperatively, serum AFP levels fell to normal. A recurrent tumor was discovered in the omentum after adjuvant chemotherapy, but serum AFP remained normal. A second laparotomy was performed and the recurrent tumor showed only fibrosarcoma-like features. The patient received second line chemotherapy and is currently in remission. This is the first case of AFP production by heterologous gastrointestinal epithelium in SLCT.

    Original languageEnglish
    Pages (from-to)418-421
    Number of pages4
    JournalJournal of Obstetrics and Gynaecology Research
    Volume34
    Issue number3
    DOIs
    Publication statusPublished - 2008 Jun 1

    Keywords

    • Alpha-fetoprotein
    • Heterologous gastrointestinal epithelium
    • Ovary
    • Sertoli-Leydig cell tumor

    ASJC Scopus subject areas

    • Obstetrics and Gynaecology

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