Androblastoma of the ovary with heterotopic elements

Hormone-producing tumors of the ovary

The ovary is an endocrine organ that gives rise to a wide variety of neoplastic and tumorlike nonneoplastic conditions, some of which are associated with endocrine activity. The hormones produced may be steroidal or nonsteroidal. The ovary is unique among endocrine organs in reacting to the presence of nonendocrine tumors within it by abnormal or inappropriate production of sex steroidal hormones. A classification of hormone-producing ovarian lesions is proposed based on the World Health Organization's histologicai typing of ovarian tumors.

Bilateral Sertoli-Leydig cell tumor with heterologous elements: report of an unusual case and review of the literature

A case of bilateral ovarian Sertoli-Leydig cell tumor with heterologous elements is reported in an 18-yr-old girl with marked virilization. Panhysterectomy was performed, yet the tumor recurred shortly after the intervention. The microscopic picture was one of intermediate to poor differentiation. Despite chemotherapy, the postoperative course was rapidly malignant, and the patient died 4 wk later.

Testicular (Sertoli's cell)-like tumors of the ovary induced by N-ethyl-N-nitrosourea (ENU) in rats

N-ethyl-N-nitrosourea (ENU) administered intraperitoneally or transplacentally to Sprague-Dawley (CD) and BD-IV (Berlin Druckrey IV) rats increased the incidence (26.6%) of an uncommon ovarian tumor with testicular characteristics compared either to controls (3.0%) or rats administered diethylnitrosamine (3.3%). The induced tumors were composed of tubular structures that resembled seminiferous tubules lined by Sertoli's-like cells. The abundant electron-lucent cytoplasm of the tumor cells contained polyribosomes, lipid bodies, and mitochondria but few additional organelles. Sertoli's cell-like tumors appeared to develop from the ovarian stroma in the hilar region of the ovary. They usually were benign and resulted in unilateral enlargement of the ovary. The mean serum concentrations of testosterone, estrone, and estradiol in selected rats with ovarian tumors were elevated above mean serum values in controls. There was not a consistent direct correlation between tumor diameter and circulating hormone level. Ethyl nitrosourea-induced ovarian tumors composed of testicular (Sertoli's-like) cells will provide a reproducible animal model to investigate the histogenesis and hormone secreting properties of this unique gonadal neoplasm.

Sex cord-stromal tumours of the ovary

The aim of this review is to give a reasonably concise resumé of our knowledge of the sex cord-stromal tumours of the ovary. Lipoid cell tumours of the ovary are often included within this broad category but this poorly defined and heterogenous group of neoplasms will not be considered here. This review is a selective one and no attempt is made to cover all aspects of sex cord-stromal tumours or to provide a complete bibliography. The histological features of many of the neoplasms in this group, particularly those which have been recently defined, are discussed but a consideration of differential histological diagnosis is excluded. The ultrastructural characteristics of the various neoplasms are considered only in terms of their relevance to histogenesis or metabolic activity.

Ovarian Sertoli-Leydig cell tumors with heterologous elements. I. Gastrointestinal epithelium and carcinoid: a clinicopathologic analysis of thirty-six cases

Thirty-six ovarian Sertoli-Leydig cell tumors containing heterologous elements in the form of gastrointestinal-type epithelium are described. Eight of the cases contained microscopic foci of insular carcinoid; in two of these cases of foci of goblet cell carcinoid were also present. The patients' ages ranged from 4-67 years (average, 23 years). The presenting manifestations were androgenic changes (18 cases), abdominal swelling (15 cases), acute abdominal symptoms (one case), menstrual irregularities (one case), and postmenopausal bleeding (two cases). All of the tumors were unilateral. The surface of the tumor was intact in 32 cases, ruptured in three, and adherent to the diaphragm in one. The tumors usually had both cystic and solid components and averaged 15.0 cm in diameter; mucinous fluid was noted on gross examination in 12 cases. On microscopic examination, the gastrointestinal epithelium contained mucinous cells, columnar cells and argentaffin cells; rarely Paneth cells were seen. It was cytologically benign in 29 cases, of borderline malignancy in five and malignant in two. Follow-up information, available for 31 patients, revealed that 29 were alive without evidence of disease from 1-17 years (average, six years) postoperatively. One patient, who had a poorly differentiated tumor, died of recurrent disease six years after the initial operation.

Sertoli-Leydig cell tumor of the ovary with teratomatous differentiation: clinicopathologic considerations

A patient with recurrent Sertoli-Leydig cell tumor is described. The light and ultrastructural findings are illustrated. The tumor recurred first as a poorly differentiated tumor with rhabdomyoblastic differentiation. Following chemotherapy the next recurrence exhibited well differentiated Sertoli-Leydig cell elements. These findings may reflect the capability of this tumor type to undergo chemotherapeutic transformation similar to the transformation which has been described in germ cell tumors of the ovary and testis. This observation may be of importance in the clinical management of patients with poorly differentiated Sertoli-Leydig cell tumors.

Neurohormonal peptides and argyrophil cells in an androblastoma of the ovary

An ovarian epithelial tumour is described with a compound histological structure containing features of an androblastoma with well differentiated Sertoli-Leydig cell structures and features resembling a carcinoid tumour. Scattered argyrophil cells were demonstrated in both components of the tumour. Neurohormonal peptides were found immunocytochemically in a minor fraction of the argyrophil cells. These included pancreatic polypeptide (PP), glucagon/enteroglucagon and enkephalin. These findings indicate a high degree of multipotentiality of the progenitor cells of the neoplasm.

Sertoli-Leydig cell tumors: a clinicopathologic study of 34 cases

Thirty-four cases of Sertoli-Leydig cell tumor were studied. All tumors were limited to the ovary at the time of initial surgery. Eight tumors were well differentiated, 15 were of intermediate differentiation, and 11 were poorly differentiated. Six cases contained heterologous elements. The less differentiated tumors occurred in patients with a lower median age and were more likely to produce androgenic manifestations. Follow-up of one year or longer was obtained in 15 patients, with an average follow-up in these patients of 6.1 years. Only one patient, who had a poorly differentiated tumor, died of the neoplasm in this series. Although follow-up was limited in this study, our findings suggest that the better differentiated tumors have a relatively favorable prognosis. This neoplasm is composed of sex-cord and stromal elements, and its components have the capacity to a greater or lesser extent to recapitulate the cells of the testis at different stages of development.