Ovarian Sertoli--Leydig cell tumors: MRI findings and pathological correlation

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Background

To investigate the magnetic resonance imaging (MRI) characteristics of ovarian Sertoli-Leydig cell tumors (SLCT).

Methods

The clinical, MRI and pathological findings of five cases of SLCT were reviewed retrospectively. MRI appearances of tumors including laterality, shape and size, architecture, wall, septa and vegetation, signal intensity and contrast-enhancement pattern were evaluated and correlated with pathological findings.

Results

Two tumors were solid which appeared as low signal intensity on T1-weighted imaging (T1WI) and moderate on T2-weighted imaging (T2WI) with multiple small cysts in one of them. The remaining three SLCT were multilocular cystic with the irregularly thickened wall and septa, and with solid area and mural nodules in one of them. The cystic components had the same signal intensity as urine. All the solid components were intensely enhanced after administration of contrast medium. All five tumors were pathologically intermediate differentiation and at FIGO stage I.

Conclusions

SLCT demonstrate variable MRI morphological appearances. However, the irregularly thickened wall and septa, the moderate T2WI signal intensity and obvious enhancement in the solid components are three MRI features.

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 Background

Sertoli-Leydig cell tumors (SLCT) of ovary are a rare type but well defined clinicopathologic entity of sex cord-stromal tumors, accounting for less than 0.5% of ovarian neoplasms [1]. These tumors are histopathologically characterized by the presence of variable proportions of Sertoli and Leydig cells. Most SLCT occur in young women and are at stage I (International Federation of Gynecology and Obstetrics, FIGO) [2]. Conservative surgery is acceptable for young patients who wish to preserve fertility without compromising 5-year disease-specific
survival [3]. Some clinicopathological studies of SLCT have been reported. To our knowledge, however, only three imaging case reports have been published [4-6]. The present study described the magnetic resonance imaging (MRI) appearances of five patients with SLCT by correlated with pathological findings, with the aim to be familiar with the imaging
appearances of this entity and improve the accuracy of preoperative diagnosis.....