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

Background: Sertoli-Leyclig 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-Leyclig 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.