GYNOB3 Sex cord tumor with annular tubules in a 15-year-old nulligravida. (Gynecology & Obstetrics).

GYNOB3 SEX CORD TUMOR WITH ANNULAR TUBULES IN A 15-YEAR-OLD NULLIGRAVIDA. Andrea Cooke Hinton, MD, and Donald C. Gallup, MD, FACOG. Memorial Medical Center, Savannah, Ga.

Sex cord tumors with annular tubules (SCTAT) are neo-plasms that represent an intermediate histological type between Sertoli cell and Granulosa cell tumors. SCTAT tumors typically present with menorrhagia in the third decade of life. A review of the literature reveals that cases found in young adolescents are rare and usually associated with Peutz-Jeghers syndrome. When SCTAT tumors are found in association with Peutz-Jeghers syndrome, they are small, multifocal, and calcified. SCTAT tumors not associated with Peutz-Jeghers syndrome are comparatively larger in size, unilateral and without calcification or multifocality. This case report will review a 15-year-old nulligravida with a SCTAT tumor not associated with Peutz-Jeghers syndrome. She presented with a one-month history of heavy menses with dysmenorrhea. An ultrasound revealed a multilobulated mass attached to the right ovary measuring 5.9 cm x 4.0 cm. Over the following month, the mass increased in size to 8.4 cm x 5.1 cm. CA-125 level was 25, AFP was 5 .3, and hCG was < 5. She underwent an exploratory laparotomy, a right salpingo-oophorectomy with an infracolic omentectomy, pelvic lymph node dissection, high common iliac node sampling, and an incidental appendectomy. At the time of surgery, the mass was noted to be smooth in appearance, obscuring any normal ovarian tissue or architecture. Pathologic diagnosis revealed a smooth surfaced multicystic ovarian mass with discrete areas of annular tubules. The omentum and lymph nodes were negative for tumor. Postoperative CA-125 level was 11, and serum Inhibin was normal. She will be followed closely with serial CA-125 levels, serum Inhibin levels, and pelvic ultrasounds.