A clinicopathological analysis of 40 cases of ovarian Sertoli-Leydig cell tumors
A clinicopathological analysis of 40 cases of ovarian Sertoli-Leydig cell tumors
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卵巢支持间质细胞瘤40例临床病理分析
DOI：
10.1016/j.ygyno.2012.07.114
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发表时间：
2012-11-01
影响因子：
4.7
通讯作者：
Guo, Lina
中科院分区：
文献类型：
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作者：
Gui, Ting;Cao, Dongyan;Guo, Lina
Objective.目的探讨卵巢支持-间质细胞瘤（SLCTs）的临床病理特点及合理的治疗方法。回顾性分析40例SLCT的临床资料。SLCT的发生率为0.41%，中位年龄为28岁。所有肿瘤均局限于一侧卵巢。高分化4例，中分化14例，低分化20例，未确定2例; 2例具有异源成分，3例具有网状模式。将患者分为3组：雄激素过多（25/40），雌激素过多（6/40）和无内分泌变化（9/40）。肿瘤直径>10 cm者分别占8.0%、16.7%和40.0%，低分化者分别占40.0%、50.0%和77.8%，肿瘤破裂者分别占20.0%、16.7%和66.7%。1例行子宫切除术，27例行单侧输卵管卵巢切除术，12例行全子宫切除加双侧输卵管卵巢切除术。共23例患者接受术后化疗。1例患者死于糖尿病肾病，3例失访。其余36例随访12 ~ 377个月，平均70.4个月。2例分化较差的Ic期肿瘤患者分别在13个月和21个月内复发，经二次手术和化疗后均获得完全缓解。SLCT预后良好，但低分化肿瘤可能复发。对于希望保留生育能力的年轻患者，保守性手术是可以接受的，对于有高危因素的患者，建议术后辅助化疗和长期随访。(C)2012 Elsevier Inc. All rights reserved.
Objective. To evaluate the clinicopathological features of ovarian Sertoli-Leydig cell tumors (SLCTs) and to explore the reasonable therapy.Methods. A total of 40 cases of SLCTs were retrospectively reviewed.Results. The incidence of SLCTs was 0.41%, with a median age of 28 years. All tumors were confined to one ovary. Four tumors were well differentiated, 14 were intermediately differentiated, 20 were poorly differentiated, and 2 were undefined; 2 cases had heterologous elements, and 3 had a retiform pattern. The patients were classified into 3 groups: androgen excess (25/40), estrogen excess (6/40), and no endocrine changes (9/40). The percentages of tumors >10 cm in diameter were 8.0%, 16.7% and 40.0%, respectively; the percentages of poor differentiation were 40.0%, 50.0% and 77.8%, respectively; and the percentages of tumor rupture were 20.0%, 16.7% and 66.7%, respectively. One patient underwent cystectomy, 27 underwent unilateral salpingo-oophorectomy, and 12 underwent total hysterectomy and bilateral salpingo-oophorectomy. A total of 23 patients received postoperative chemotherapy. One patient died of diabetic nephropathy, and 3 were lost to follow up. The remaining 36 were followed up from 12 to 377 (average 70.4) months. Two patients with stage Ic tumors of poor differentiation had a recurrence within 13 and 21 months, and both obtained complete remission after the second surgery and chemotherapy.Conclusions. The prognosis of SLCTs is good, although poorly differentiated tumors may recur. Conservative surgery is acceptable for young patients wishing to preserve fertility, and postoperative adjuvant chemotherapy and long-term follow up are recommended to those with high-risk factors. (C) 2012 Elsevier Inc. All rights reserved.