1. Diagnosis: Sertoli-Leydig Cell Tumor, Well-differentiated.  This is a gonadal stromal tumor of the Sertoli-Leydig cell type, formerly called arrhenoblastoma. These tumor account for less than 0.5% of all ovarian tumors, but they are among the most interesting from both the pathology and clinical viewpoints.

While they may occur at any range, they are most often encountered in women less than 30 years of age.

Microscopically they are composed of hollow tubular structures lined by Sertoli cells separated by large pink cells, which may contain a brown granular pigment typical of Leydig cells. The tumor is grossly yellow at times and surgeons mistake these tumors for corpora lutea.

2. After removal of a virilizing Sertoli-Leydig cell tumor, normal menses usually resume. The prognosis is closely related to tumor stage and degree of differentiation (well, intermediate, poorly differentiated tumors). Tumors that are confined to the ovary at the time of Surgery (Stage I) may be treated by oophorectomy. If higher stage, a TAH-BSO should be performed. Tumors that follow a malignant course, tend to recur early (compared to Granulosa cell tumors which may recur 20 years lager), and recurrences are often within the pelvis. Distant metastatic disease is less common.

3. Review of ovarian tumors – see Slide C (Reference Robbins' textbook).