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Ovarian Sertoli‐Leydig cell tumor with heterologous gastrointestinal epithelium as a source of alpha‐fetoprotein: A case report
Author(s) -
Watanabe Takafumi,
Yamada Hidekazu,
Morimura Yutaka,
Abe Masafumi,
Motoyama Teiichi,
Sato Akira
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00730.x
Subject(s) - medicine , pathology , alpha fetoprotein , heterologous , ovary , gastrointestinal epithelium , immunohistochemistry , epithelium , biology , biochemistry , gene , hepatocellular carcinoma
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.