Oncology and Fibroids
The ovarian tumor which is most likely to be associated with virilization (AIIMS Nov 2012)
|B||Sertoli-Leydig cell tumor|
1. Sertoli-Leydig cell tumors, which represent less than 1% of ovarian tumors, may produce symptoms of virilization. Histologically, they resemble fetal testes; clinically, they must be distinguished from other functioning ovarian neoplasms as well as from tumors of the adrenal glands, since both adrenal tumors and Sertoli-Leydig tumors produce androgens.
2. The androgen production can result in seborrhea, acne, menstrual irregularity, hirsutism, breast atrophy, alopecia, deepening of the voice, and clitoromegaly Recurrences of Sertoli-Leydig cell tumors, which seem to have a low malignant potential, usually appear within 3 years of the original diagnosis.
3. Granulosa and theca cell tumors are often associated with excessive estrogen production, which may cause pseudoprecocious puberty, post- menopausal bleeding, or menorrhagia.
4. These tumors are associated with endometrial carcinoma in 15% of patients. Because these tumors are quite friable, affected women frequently present with symptoms caused by tumor rupture and intraperitoneal bleeding.
5. Granulosa tumors are low-grade malignancies that tend to recur more than 5 years after the initial diagnosis. Because their malignant potential is impossible to predict histologically, long- term follow-up is mandatory.