Would you consider adjuvant chemotherapy in a young patient with stage IC1 Sertoli-Leydig cell tumor, moderately differentiated, with heterologous (rhabdosarcomatous) component and retiform elements?

This young patient has several high-risk criteria for recurrence. Thus, I favor offering her adjuvant systemic platinum-based chemotherapy with 6 cycles of carboplatin + paclitaxel.

Background:

Sertoli-Leydig cell tumors (SLCTs) are sex-cord stromal tumors and account for less than 0.5% of primary ovarian tumors. They usually occur in young reproductive women and present with Stage I disease as a unilateral ovarian mass. They often secrete androgens, exhibiting clinical signs of androgen excess in about half of cases. Less frequently, estrogenic manifestations occur. The prognosis of SLCTs is overall very good with 5-yr survival > 90% for Stage I disease.

The pathologic diagnosis of SLCTs is challenging due to significant morphologic overlap w...