Frozen Section Diagnostic Pitfalls of Sertoli-Leydig Cell Tumor with Heterologous Elements

Case Reports in Pathology
Ashley BurrisNathaniel Smith

Abstract

A woman in her sixth decade presented with several months of abdominal cramping, decreased appetite, bloating, and increased constipation. Radiologic imaging revealed a 28 cm, multilocular, heterogeneous cystic neoplasm involving the right adnexa. An intraoperative frozen section showed mucinous glandular epithelium, with and without foci of goblet cells, embedded in apparent ovarian stroma. The findings were concerning at least borderline mucinous cystadenoma with possible invasion. Subsequent surgical management and staging were performed. Permanent sections showed a moderately to poorly differentiated Sertoli-Leydig cell tumor (SLCT) with retiform foci and heterologous elements. The discrepancy between frozen and permanent sections was attributable to solely sampling a focus of heterologous elements during intraoperative consultation. The rarity of SLCT and even rarer presence of both heterologous and retiform elements make this concerning frozen section diagnostic pitfall.

References

Jun 1, 1984·The American Journal of Surgical Pathology·C Zaloudek, H J Norris
Oct 27, 2004·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Robert H Young
Sep 26, 2006·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Cleide Mara Mazzotti de Oliveira FranzinEmílio Francisco Marussi
Jul 24, 2013·Case Reports in Obstetrics and Gynecology·Ahmed Abu-ZaidTurki Omar Al-Hussain
May 2, 2014·Journal of Clinical and Diagnostic Research : JCDR·Rohini Dhanya C SRenu G'boy Varghese

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Methods Mentioned

BETA
dissection
biopsies
imaging technique

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