Ovarian Sertoli-Leydig cell tumors with heterologous elements. II. Cartilage and skeletal muscle: A clinicopathologic analysis of twelve cases

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Abstract
Twelve ovarian Sertoli-Leydig cell tumors that contained heterologous elements in the form of skeletal muscle (9 cases), cartilage (7 cases) and neuroblastoma (1 case) in either the primary or recurrent specimens are reported. Four of the primary tumors also contained foci of gastrointestinal type epithelium with argentaffin cells identifiable in 2 of them. The age of the patients ranged from 11-48 yr (averge, 24 yr). Ten patients presented with an abdominal mass, 1 with abdominal pain and 1 with acute abdominal symptoms. Five of the patients, 2 of whom were virilized and 1 of whom was hirsute, had evidence establishing or suggesting androgen overproduction. All the tumors were unilateral. Four had ruptured preoperatively and 2 ruptured during the operation. All the tumors were unilateral. Four had ruptured preoperatively and 2 ruptured during the operation. The tumors averaged 18.5 cm in greatest diameter and had extensive areas of hemorrhage and necrosis in half the cases. On microscopic examination the Sertoli-Leydig cell component was poorly differentiated in 11 cases and of intermediate differentiation in 1 case. In 2 cases the primary tumor was a poorly differentiated Sertoli-Leydig cell tumor and heterologous elements were identified only in a recurrent mass. Follow-up of 10 patients revealed that 8 of them had died of tumor from 5 mo.-7 yr postoperatively.