A 16-year-old girl presents with secondary amenorrhoea, acne, deepening voice and clitoromegaly over 6 months. Ultrasound shows a 12 cm unilateral solid right ovarian mass. Serum testosterone is markedly elevated, LH and FSH are normal, and inhibin B is raised. Histology shows hollow tubules lined by Sertoli cells admixed with clusters of Leydig cells containing Reinke crystals. What is the diagnosis?
- A Adult granulosa cell tumour
- B Pure Leydig cell tumour
- C Sertoli-Leydig cell tumour (androblastoma) ✓
- D Gynandroblastoma
Correct answer: C. Sertoli-Leydig cell tumour (androblastoma)
Explanation
The combination of virilisation, a solid ovarian mass, and histology showing both Sertoli-derived tubules and Leydig cells with Reinke crystals defines a Sertoli-Leydig cell tumour, seen mainly in young women. Pure Leydig cell tumour lacks the Sertoli tubular component. Adult granulosa cell tumour causes oestrogenic rather than androgenic effects. Gynandroblastoma contains significant components of both granulosa and Sertoli elements, which is absent here.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.