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Background <p>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.</p> Case presentation <p>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.</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月18日

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  • Siting Lin,
  • Man Zhang,
  • Manli Wu,
  • Xinling Zhang

摘要

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.