Elevation of Alpha-Fetoprotein in Sertoli-Leydig Cell Tumor: A Case Report

Abstract

Sertoli-Leydig cell tumors represent about 0.2 to 0.5% of all primary ovarian tumors. One of the main features of this type of tumor is the high production of androgens, which promotes hirsutism and virilization. This case reports a 28-year-old patient with severe abdominal pain whose physical examination showed a right adnexal mass, confirmed by pelvic US, without clinical evidence of virilization, who presented elevated alpha-fetoprotein (636 ng/mL), negative hCG-β and was negative to other tumor markers. Exploratory laparotomy was performed with right salpingo-oophorectomy. Histologically, it was identified a tumor with het erogeneous areas, retiform, tubular, microcystic, anastomosing cords and trabeculae with Ley dig cells and areas of hepatoid differentiation. The tumor was positive for inhibin, cytokeratin AE1/AE3 and calretinin. One week after surgery, alpha-feto protein levels dropped to 150 ng/ml and to 0.89 ng/ml five months later. This is a case of Sertoli-Leydig cell tumor with elevated alpha fetoprotein no evidence of virilization and the histological pattern showing focal areas of hepatoid differentiation.