Sertoli-Leydig cell tumors of the ovary and pregnancy

Sertoli-Leydig cell tumors represent less than 0.2% of all ovarian tumors and approximately 1% of ovarian malignancies discovered during pregnancy. Typically, ovarian malignancies during pregnancy are initially discovered as adnexal masses on routine prenatal ultrasonography. Because of the small risk of malignancy and the greater threat of torsion or obstruction of labor, persistent adnexal masses should be surgically excised at about 16 to 20 weeks of gestation. Approximately 5% of adnexal masses are malignant. Evaluation of the pathologic features is essential to determine the surgical and postoperative management of gravid women with a Sertoli-Leydig cell tumor of the ovary. Well-differentiated tumors may be treated adequately with unilateral salpingo-oophorectomy. Appropriate staging is required for tumors that are less differentiated. In both gravid and non-pregnant women, most Sertoli-Leydig cell tumors are confined to the ovary. In cases of tumors of advanced stage or grade, chemotherapy should at least be considered.