Contrast-enhanced ultrasound findings of ovarian Sertoli-Leydig cell tumor: a case report with ultrasonographic–pathological insights

Abstract Background Ovarian Sertoli-Leydig Cell Tumors (SLCTs) are exceedingly rare sex cord-stromal tumors with non-specific clinical features and limited diagnostic imaging. We evaluated the ultrasonographic-pathological correlation of ovarian SLCT and explored the clinical value of contrast-enhan...

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Bibliographic Details
Main Authors: Siting Lin, Man Zhang, Manli Wu, Xinling Zhang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Women's Health
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Online Access:https://doi.org/10.1186/s12905-025-03910-0
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Summary:Abstract Background Ovarian Sertoli-Leydig Cell Tumors (SLCTs) are exceedingly rare sex cord-stromal tumors with non-specific clinical features and limited diagnostic imaging. We evaluated the ultrasonographic-pathological correlation of ovarian SLCT and explored the clinical value of contrast-enhanced ultrasound (CEUS) through a case analysis of a 62-year-old woman with a SLCT. Case presentation A 62-year-old postmenopausal woman presented with abdominal distension. Serum testosterone was elevated (4.43 nmol/L; normal range 0.45-1.26nmol/L). Ultrasound revealed a large multilocular cystic lesion with solid components in the pelvic-abdominal region, marked by abundant blood flow within the septa and solid areas, along with low-resistance arterial flow in the solid component of the tumor. CEUS demonstrated rapid and heterogeneous high enhancement in the tumor’s cystic wall, septa, and solid components during the wash-in phase. Additionally, there was early washout compared to the myometrial layer. Total hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology confirmed moderately-poorly differentiated SLCT. Conclusions The CEUS pattern of SLCT (rapid heterogeneous hyperenhancement with early wash-out) is similar to that of malignant ovarian tumors. The diagnosis of SLCT cannot rely solely on imaging findings. Integrated clinical and laboratory findings are crucial for differentiating SLCT from ovarian cancer.
ISSN:1472-6874