A 19-year-old girl presents with recent onset hirsutism, deepening voice and clitoromegaly. Ultrasound shows a 9 cm solid unilateral right adnexal mass. Serum testosterone is markedly elevated while DHEAS is normal. Histology would MOST likely show:
- A Granulosa cells arranged around eosinophilic fluid-filled spaces
- B Leydig cells admixed with tubules lined by Sertoli cells ✓
- C Large primitive germ cells with clear cytoplasm and lymphocytic infiltrate
- D Signet ring cells within a hypercellular stroma
Correct answer: B. Leydig cells admixed with tubules lined by Sertoli cells
Explanation
Sertoli-Leydig cell tumour is an ovarian sex cord-stromal neoplasm of intermediate differentiation that secretes androgens directly, producing virilisation with normal DHEAS because the source is ovarian rather than adrenal. Histology shows Sertoli cells forming tubules admixed with clusters of Leydig cells, which may contain Reinke crystals. Call-Exner bodies point to granulosa cell tumour, which causes oestrogen excess rather than virilisation.
Reference: Williams Gynecology, 3rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.