ii) Sertoli-Stromal Tumours


The Sertoli-Leydig group contains most of these tumours, which are made up of a combination of Sertoli cells, Leydig cells, and stromal elements. They are rare tumours (<0.5%).
Sertoli-cell tumours contain Sertoli cells with no Leydig cells. They are even rarer than the Sertoli-Leydig group.


Aside from being very rare, both Sertoli-Leydig and Sertoli cell tumours often occur in the 20-30 age bracket.



Clinical Features

Despite appearing as Leydig or Sertoli cells, these tumours may produce oestrogens, androgens, or neither. Androgen production is more common (1/3rd of cases) in Sertoli-Leydig tumours, causing virilisation. Oestrogen producing tumours may cause menstrual irregularities or precocious puberty.

Pathological Features

Macroscopically, the tumour may be solid, cystic or both and is often yellow.
Microscopically, Sertoli-Leydig tumours have a variable appearance. Well-differentiated tumours contain tubules lined by Sertoli cells surrounded by a stroma containing fibrous and Leydig cell clusters. As differentiation worsens, the tubules become less apparent and the tumour may consist of atypical spindle cells.
Sertoli cell tumours contain tubules with no evidence of Leydig cells. The tubules range from single lumen to cribriform in appearance.