1
Fifth stage
Gynecology
Lec-7
د. احمد جاسم
6/4/2016
Sex cord-stromal tumour
• Sex cord-stromal tumour is a group of tumours of sex cord-derived tissues of the
ovary and testis .It accounts for 8% of ovarian cancers and a minority of testicular
cancers.
• This group consists of:
• Thecoma
• Fibroma
• These tumours tend to be functional ,producing estrogens or androgens .They may
have dramatic clinical presentations. Almost all are unilateral.
Granulosa cell tumour
• Granulosa cell tumo(u)rs
( or granulosa-theca cell tumo(u)rs )are tumors of the
granulosa cell .They are part of the sex cord-stromal tumour group of ovarian
neoplasms.
• The peak age at which they occur is 50-55 years, but they may occur at any age.
Clinical presentation
• Estrogens are produced by functioning tumours, and the clinical presentation
depends on the patient's age.
• If the patient is postmenopausal ,she usually presents with abnormal uterine
• If the patient is of reproductive age ,she would present with menometrorrhagia .
However, in some cases she may stop ovulating altogether .
• If the patient has not undergone puberty ,isosexual-pseudo-precocity may be seen .
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Histology
• The most characteristic gross appearance is a smooth surfaced solid and cystic lesion
with the cysts filled with blood .Hemoperitoneum is an infrequent but classical
presentation. A large variety of histological presentations exists, but they have two
key features:
( granulosa cells arranged haphazardly around a space containing
eosinophilic fluid ;)and
• Pale uniform nuclei, often with grooves
• There have been cases where the tumor presented as a single, cyst-like, space, with
no internal bleeding.
Sertoli-Leydig cell tumour
• Sertoli-Leydig cell tumour ,also known as arrhenoblastoma or androblastoma ,is a
member of the sex cord-stromal tumour group of ovarian and testicular cancers .
The tumour is rare, comprising less than 1% of ovarian tumours. While the tumour
can occur at any age, it occurs most often in young adults.
Classification
• The tumour is subdivided into many different subtypes. The most typical is composed
of tubules lined by Sertoli cells and interstitial clusters of Leydig cells.
Presentation
• Due to excess testosterone secreted by the tumour, one-third of female patients
present with a recent history of progressive masculinization .Masculinization is
preceded by anovulation ,oligomenorrhea ,amenorrhea and defeminization .
Additional signs include acne and hirsutism ,voice deepening ,clitoromegaly ,
temporal hair recession, and an increase in musculature. Serum testosterone level is
high.
Diagnosis
• A recent study has shown that CD56 can be a marker for tumors of this class.
Treatment
• Treatment consists of surgical resection alone with a unilateral salpingo-
oophorectomy. The prognosis is generally good as the tumour tends to grow slowly
and usually is benign
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