Stage I Ovarian Sertoli-Leydig Cell Tumor in a 19-Year-Old

What happened, in summary

A 19-year-old woman developed abdominal pain and sudden bloating. Imaging showed a complex mass confined to the right ovary, and her AFP tumor marker was elevated. She also had a striking family history: an older sister had died from ovarian cancer at age 11.

Because the mass appeared suspicious but resectable, she chose fertility-preserving treatment. Surgery removed the right ovary and fallopian tube, along with part of the omentum and several peritoneal biopsies. The tumor had ruptured through its capsule, but no lymph node enlargement or peritoneal implants were found. Pathology identified a poorly differentiated Sertoli-Leydig cell tumor with a very small area of gastrointestinal-type tissue. The report classified the tumor as Stage I because disease remained confined to the ovary despite capsular rupture.

Her AFP level became undetectable after surgery. Given the poor differentiation and heterologous elements, she started bleomycin, etoposide, and cisplatin chemotherapy. At the time of publication, she had completed about 4 months of treatment without major complications.