Journal of Pediatric Surgery Case Reports
Sertoli-Leydig cell Tumor in a 16-year-old female: a case report
By Asmaa Abo talib, Majeed Shallan, Anas Al-Kubati and 3 others.
Abstract
Introduction
Less than 0.5% of all primary ovarian tumors are Sertoli-Leydig cell tumors (SLCT), which are androgen-secreting tumors that cause virilization features such as secondary amenorrhea, hirsutism, increased muscle mass, voice deepening, and clitoromegaly.
Case presentation
A 16-year-old female patient presented with a three-year history of secondary amenorrhea, progressive hirsutism, and clitoromegaly. Laboratory tests revealed significantly elevated testosterone levels (total testosterone: 14 nmol/L; normal range: < 2.4 nmol/L), while adrenal function tests (DHEA-S, cortisol, and 17-hydroxyprogesterone) and other tumor markers (CA-125, alpha-fetoprotein, inhibin-B, and Beta-HCG) were normal. An abdominopelvic ultrasound revealed a 3.5 × 3.5 cm well-demarcated, solid-cystic mass in the left ovary, with normal contralateral (right) ovary and adrenal glands. An abdominopelvic CT scan identified a 3.5 × 3.5 × 2.5 cm heterogeneously enhancing solid-cystic mass in the left ovary, with no evidence of metastasis. The patient underwent unilateral left oophorectomy, preserving the uterus and the contralateral (right) ovary to maintain fertility. Intraoperative findings confirmed a smooth-surfaced, encapsulated left ovarian mass (Stage IA). Histopathological and immunohistochemical analysis confirmed a well-differentiated SLCT. Postoperatively, serum testosterone levels normalized within seven days, and regular menstruation resumed within one month.