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What is sertoli-leydig cell tumor of the ovary?
Sertoli-Leydig cell tumors are a rare type of ovarian tumor that belong to the 'sex cord-stromal' family — tumors that grow from the ovary's hormone-producing support cells rather than its egg cells. They are named for the two cell types they contain (Sertoli and Leydig cells, normally found in the testicle), and many of them produce male hormones (androgens). This can cause signs such as irregular or absent periods, acne, a deeper voice, or increased body hair, which often prompt the diagnosis. They typically occur in teenagers and young women. Most are found early, confined to one ovary, and are cured by surgery alone. A notable subset is linked to inherited changes in a gene called DICER1, so genetic counseling is often recommended, especially in younger patients. Because behavior ranges from harmless to occasionally aggressive, the tumor's grade (how mature or 'well-differentiated' it looks) guides whether extra treatment is needed.
The main types
Doctors group sertoli-leydig cell tumor of the ovary by where it starts and how it behaves:
| Type | What it means, simply |
|---|---|
| Well-differentiated | Looks mature and orderly under the microscope; almost always benign and cured by removing the affected ovary. |
| Intermediate (moderately differentiated) | An in-between appearance; usually behaves well but is watched more closely, and treatment may be added if other risk features are present. |
| Poorly differentiated | Looks immature and disorganized; the most likely to behave aggressively and the group most often considered for chemotherapy. |
| With heterologous elements / retiform pattern | Contains extra tissue types (such as mucus glands or cartilage) or a net-like growth pattern; more often linked to DICER1 changes and to a somewhat higher risk of recurrence. |
Staging, in plain terms
Sertoli-Leydig cell tumors use the same FIGO stages as other ovarian cancers to describe spread, but the tumor's grade (how differentiated it is) is just as important for predicting behavior. Most are stage I — confined to one ovary — when found.
| Ovarian cancer FIGO staging (with grade emphasized) | What it generally means |
|---|---|
| Stage I | Confined to one (or rarely both) ovary. The great majority of cases, usually cured by surgery, especially when well-differentiated. |
| Stage II | Spread to other pelvic structures. Less common; may prompt added chemotherapy depending on grade. |
| Stage III | Spread to the abdominal lining or lymph nodes. Uncommon; treated with surgery plus chemotherapy. |
| Stage IV | Spread to distant organs. Rare for this tumor; managed with combined therapy at an expert center. |
The standard of care
Sertoli-Leydig Cell Tumor of the Ovary is almost always treated by a team that may include a surgeon, a medical oncologist, and a radiation oncologist, combining therapies for the best result. The usual building blocks are:
Fertility-sparing surgery
For early, one-sided tumors in young women, removing just the affected ovary and tube usually cures the cancer while preserving fertility and hormones.
More extensive surgery
For older patients who have completed childbearing, or for advanced tumors, more complete surgery with staging is performed.
Chemotherapy
Reserved mainly for poorly differentiated tumors, those with high-risk features, or advanced/recurrent disease — usually a platinum-based regimen similar to that used for ovarian germ-cell tumors.
Genetic counseling (DICER1)
Testing for inherited DICER1 changes is offered because it affects screening for the patient and family members for related tumors.
How radiation treatment works
Radiation damages the DNA inside cancer cells so they can no longer divide and survive, while normal cells repair themselves more effectively. For Sertoli-Leydig cell tumors, surgery is the main treatment and radiation has only a limited, selective role — for example, to control an isolated area of recurrence or to relieve symptoms. When it is used, it is delivered as short, painless daily sessions and leaves no radioactivity in your body, so you remain safe to be around family and children.
The main ways radiation is delivered for sertoli-leydig cell tumor of the ovary:
Radiation (selective)
Radiation is not a routine treatment for these tumors; it is used occasionally to control a specific site of recurrence or to relieve symptoms when surgery and chemotherapy are not options.
Stereotactic / focused radiation
When a single area of recurrent disease needs treatment, precisely targeted high-dose radiation can control it while sparing surrounding tissue.
Palliative radiation
Short courses of radiation can ease pain or other symptoms in the uncommon event of advanced, treatment-resistant disease.
Latest studies shaping care
Care keeps improving — often toward getting the same excellent results with less burden on patients. A few developments:
DICER1 syndrome link clarified: Research has established that a meaningful share of Sertoli-Leydig cell tumors — particularly moderately/poorly differentiated and retiform types — carry DICER1 mutations that can be inherited, supporting routine genetic counseling.[1]
DICER1 tumor predisposition reviews (2021–2025)
Fertility-sparing surgery is safe for early tumors: Series confirm excellent outcomes with conservative, fertility-preserving surgery for stage I well-differentiated tumors, avoiding unnecessary chemotherapy.[2]
Gynecologic oncology outcome studies (2022–2024)
Chemotherapy targeted to high-risk disease: Platinum-based chemotherapy is reserved for poorly differentiated, advanced, or recurrent tumors, where it improves control, while low-risk tumors are spared its toxicity.[3]
Rare ovarian tumor consensus reviews (2023–2025)
Common questions
Will I still be able to have children? Usually yes. For young women with an early, one-sided tumor, surgeons can often remove only the affected ovary and fallopian tube, preserving the other ovary, the uterus, and fertility. Your team will tailor the plan to your situation.
Why did my voice deepen or my periods stop? Many of these tumors make male hormones, which can cause acne, increased body hair, a deeper voice, or changes in periods. These signs often lead to the diagnosis and usually improve after the tumor is removed.
Why am I being referred for genetic testing? Some Sertoli-Leydig cell tumors are caused by an inherited change in the DICER1 gene, which can predispose to a few other rare tumors. Testing helps guide monitoring for you and lets relatives know whether they should be checked too.
References
Numbered sources for the studies cited above. Links open the primary publication on PubMed or the publisher’s site.