Androblastoma of the ovary: Clinical, diagnostic and histopathologic features

Androblastomas of Sertoli-Leydig cell tumors of the ovaries are classified into the group of sex cord stromal tumors and represent an extremely rare f orm of tumor (0.2% of all ovarian tumors) in women. Their malignant potenti al is lower than that of epithelial ovarian cancer. They cause signs of vir ilization, although these are not obligatory. In many cases secondary ameno rrhea is the only symptom of the disease. This leads to an intensive search for the source of the disorder. Frequently only the elevated production of androgens gives a preoperative clue to the tumor type. The recommendation to include the measurement of androgen levels in the routine diagnosis of s econdary amenorrhea must therefore be endorsed. The tumors are usually sono graphically identifiable; in differential diagnosis, hyperandrogenemia of o ther origins (e.g., Cushing's disease, adrenal hyperplasia, pituitary adeno ma, other causes of ovarian and adrenal androgen hypersecretion, intersexua lity, medically induced androgenization) have to be ruled out. In view of t he good prognosis, the therapy of choice consists simply in adnexectomy of the affected side. With regular measurement of serum androgen levels an eff ective control of the course of the disorder is possible. A conclusive path ological diagnosis is difficult as heterologous tumors and mixed tumors exi st and, furthermore, other tumor types are capable of imitating Sertoli-Ley dig cell tumors.