Sertoli—Leydig tumors of the ovary A clinicopathologic study of 64 intermediate and poorly differentiated neoplasms*

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Abstract
The clinical and pathologic features of 64 Sertoli-Leydig tumors of the ovary with intermediate and poor differentiation were studied. The neoplasms occurred mainly in young women. Of the patients, 54% presented with clinical evidence of a hormonally active tumor, and 38% were virilized. The remaining 46% had nonspecific symptoms. Sixty-two patients had tumors confined to 1 ovary at operation (Stage Ia), while only 2 patients presented with pelvic metastases (Stage III). The prognosis was generally favorable; the 5- and 10-yr actuarial survival rates were 92%. Unilateral salpingooophorectomy was effective treatment for Stage Ia Sertoli-Leydig tumors in young women. Microscopically, 44 of the neoplasms were of intermediate differentiation and 20 were poorly differentiated. Heterologous elements (mucinous epithelium, striated muscle, cartilage) were present in 16 neoplasms. The pathologic features that correspond with development of metastases were poor differentiation, the presence of heterologous mesenchymal elements, frequent mitotic figures in stromal cells, and rupture of the neoplasm.