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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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Use of novel serum markers in clinical follow-up of Sertoli-Leydig cell tumours

Miriam Lenhard1 / Caroline Kuemper2 / Nina Ditsch3 / Joachim Diebold4 / Petra Stieber5 / Klaus Friese6 / Alexander Burges7

1Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany

2Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany

3Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany

4Department of Pathology, Ludwig-Maximilians-University, Munich, Germany

5Department of Clinical Chemistry, Ludwig-Maximilians-University, Munich, Germany

6Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany

7Department of Obstetrics and Gynaecology, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany

Corresponding author: Miriam Lenhard, MD, Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University Munich, Campus Grosshadern, Marchioninistrasse 15, 80337 Munich, Germany Phone: +49-89-7095-0, Fax: +49-89-7095-5844,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 5, Pages 657–661, ISSN (Online) 14346621, ISSN (Print) 14374331, DOI: 10.1515/CCLM.2007.120, May 2007

Publication History

Received:
2006-12-19
Accepted:
2007-02-20
Published Online:
2007-05-07

Abstract

Background: Sertoli-Leydig cell tumours of the ovary account for only 0.2% of malignant ovarian tumours. Two-thirds of all patients become apparent due to the tumour's hormone production.

Methods: A 41-year-old patient (gravida 4, para 4) presented with dyspnoea, enlarged abdominal girth and melaena. Diagnostic imaging was suspicious for an ovarian cancer. The standard tumour marker for ovarian cancer (CA 125) was elevated to 984 U/mL.

Results: Surgical exploration of the abdomen revealed a mouldering tumour of both adnexes extending to the level of the navel. Frozen sections showed an undifferentiated carcinoma of unknown origin. Radical surgery was performed. The final histological report described a malignant sex-cord stroma tumour, a Sertoli-Leydig cell tumour, emanating from both ovaries. Analysis of preoperative blood serum showed elevated levels of CYFRA 21-1 (10.4 ng/mL), neuron-specific enolase (36.2 ng/mL), oestradiol (485 pg/mL) and CA-125 (984 U/mL). Adjuvant chemotherapy and regional hyperthermia were performed due to the malignant potential and incomplete resection of the tumour.

Conclusions: Undifferentiated Sertoli-Leydig cell tumours show a poor clinical course. As only two-thirds of patients with this rare disease present with elevated hormone levels, new markers deserve further investigation to offer more specific, individualised tumour monitoring.

Clin Chem Lab Med 2007;45:657–61.

Keywords: ovarian malignancy; Sertoli-Leydig cell tumour; serum marker; sex-cord stromal tumour

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