Ovarian Sertoli-Leydig cell tumor with hyperestrogenism in a
postmenopausal woman: A case report and review of the literature
Abstract
【Abstract】Ovarian Sertoli-Leydig cell tumors (SLCTs) are extremely
rare ovarian sex cord-stromal tumors, predominantly secreting
testosterone and occasionally manifesting with elevated estrogen levels,
such as abnormal uterine or postmenopausal bleeding. This report details
a 57-year-old postmenopausal woman with vaginal bleeding. Laboratory
findings indicated mildly suppressed follicle-stimulating hormone and
elevated estradiol. Female tumor markers showed no abnormalities. The
transvaginal ultrasound revealed thickened endometrial lining
accompanied by cystic echoes, cystic echoes in the left ovary, and no
definitive mass observed in the right ovary. Postoperative pathology
revealed atypical endometrial hyperplasia, a serous cystadenoma in the
left ovary, and a moderately differentiated SLCT in the right ovary.
Surgical approach: Total hysterectomy, bilateral adnexectomy, and
omentectomy were performed laparoscopically. Five months
postoperatively, the patient’s follicle-stimulating hormone levels were
significantly elevated, and estradiol levels markedly decreased.
Transvaginal ultrasound showed no occupying lesions in the pelvic
cavity. This case underlines the importance of recognizing elevated
hormone levels as potential indicators of SLCTs when imaging is
inconclusive, highlighting the need for early detection and treatment.