[Table/Fig-5]:

Ovarian Sertoli-Leydig cell tumors in pregnant and non pregnant female patients

Authors, Ref., year	No.of cases	Age (yreas) (mean)	Presentation, hormonal manifestation (n, %)	Site	Gross	Pathology (n, %)	IHC	Management	Outcome
Oliva et al., [4]	54	2-76 (30)	PZ syndrome (6, 11%)	Most U/L	8-30 cms, solid, yellowish areas	Tubular (most common), cords/trabeculae (28, 51%),diffuse (21, 38%), pseudopapillary (4, 7%), retiform (3, 5%), alveolar (3, 5%), spindled (3, 5%), lipid-rich (6, 11%)	Inhibin (18/22 +, 81%), Calretinin (10/20+, 50%),CD99 (19/22 +, 86%),vimentin (17/ 18+, 94%), SMA (4/18 +, 22%), NSE (8/16 +, 50%), S-100(2/20+, 10%), EMA & chromogranin- negative (100%)	U/L or B/L SO	NER 1 case of splenic metastasis
Young et al. [5]	13	Young pregnant women	Incidental, obstructed labour, rupture, androgenic (2%) during pregnancy or in postpartum	U/L	3-22 cms (15), solid –cystic (7), solid (6), yellow areas (7)	Meyer’s type II (10/13), sheets of Leydig cells (8/13), necrosis & haemorrhage(8/13), intercellular edema +, heterologous elements-gastrointestinal type (2/13)	ND	O, Intact capsule (7), p/o rupture (5), I/o rupture (1)	Recurrences in ruptured cases (70%)
Alam et al., [2]	1	17 years	Irregular menses, abdominal lump, no virilization.	B/L	Rt; 25x23x8 cms, Lt-10x 8x3 cms, solid-cystic, focal yellow areas, intact capsule	Frozen study done. Peritoneal implant+, retiform pattern, mitosis >5/10 HPF, Meyer’s type II.	ND	B/L SO	On follow up
Choudhary et al., [6]	1	18½ years, married	Sudden onset of virilization, massive ascites	B/L	Ruptured capsule	Frozen study done. B/L (malignant)	ND	TAH + B/L SO + Om, debulking CT	NER, NEM. Voice change & hirsuitism persists.
Chakrabarti et al., [3]	1	26 years	Virilization +, secondary amennorhea- 2 years. Serum testosterone- 5.2 pg/ml, reference= 0.7-3.6 pg/ml)	U/L	13x10 cms, solid–cystic, intact capsule, contain mucinous material	Cords, trabeculae of SC, clumps of LC, heterologous elements-surface epithelium of serous & mucinous differentiation	-	U/L SO + CT- BEP regimen	Symptoms free at 6 months, on follow-
Tandon R et al., [7]	1	19 years	Virilization +, amenorrhea (7 months), serum testosterone- 2ng/ml (0.2-1.2ng/ml)	U/L	10x7X2 cms, gray white, solid–cystic, clear fluid, yellowish areas, intact capsule	Cords, nests, trabeculae of SC, interspersed LC, heterologous elements- mucinous epithelium of gastrointestinal type	-	U/L SO, CT-BEP regimen	Resolution of virilization symptoms
Present case	1	25 years	H/o abortion 8 months back, irregular menses, abdominal pain & lump, virilization absent, serum testosterone-41.7 ng/ml (ref. <2.2ng/ml)	U/L	10X9 cms, solid–cystic, clear fluid, yellowish areas,intact capsule	Frozen study; s/o GCT. Cords, tubules of SC, sheets of LC. Heterologous elements absent	α-Inhibin cytoplasm positivity	U/L SO	Testosterone levels back to normal range at 4 months of follow up

α-Inhibin, alpha-inhibin; B/L, bilateral; BEP, Bleomycin, Etoposide and Cisplatin; CT, chemotherapy; EMA, epithelial membrane antigen; GCT, granulosa cell tumor; IHC, immunohistochemistry; i/o, intra-operative; LC, Leydig cells; NSE, neuron specific enolase; ND, not described; NER, no evidence of recurrence; NEM, no evidence of metastasis; O, Oophorectomy; Om, omentectomy; PJ, Peutz - Jeghers syndrome; p/o, pre-operative; SC, Sertoli cells; s/o, suggestive of; SMA, smooth muscle actin; SO, salpingo-oophorectomy; TAH, total abdominal hysterectomy; U/L, unilateral