Uncovering a Rare Hidden Source of Testosterone Secretion from Virilizing Poorly Differentiated Sertoli-Leydig Cell Tumour in a Teenage Female: A case report

A bstract Sertoli-Leydig cell tumor (SLCT) is a rare sex cord-stromal tumor accounting for <0.5% of all primary ovarian neoplasms. It occurs in all age groups, with majority occurring in the reproductive age group, mostly in the second and third decades. It is the most common virilizing ovarian tumor, autonomously secreting testosterone, leading to androgenic manifestations. A 17-year-old single nulliparous female presented with a 2-year history of oligomenorrhea, followed by amenorrhea, abdominal swelling, and features of virilism. A computed tomographic scan diagnosed a right complex ovarian mass with obstructive uropathy. She underwent a right salpingo-oophorectomy and omentectomy for a stage 1A tumor. Histopathological examination confirmed the diagnosis of poorly differentiated SLCT with a predominance of heterologous mesenchymal elements. The postoperative period was uneventful, with resumption of menstruation and regression of the androgenic signs and symptoms. Unfortunately, symptoms recurred 5 months after the initial surgery, and patient succumbed.