Sex cord tumors

One true exception to the last statement is represented by the ability of MART-l/melan-A (but not HMB-45, NKI-beteb, or HMB-50) to label the tumor cells of a subset of adrenocortical carcinomas and sex-cord tumors of the gonads (Fig. 7.13). " 4° No evidence of true melanocytic differentiation has been seen in such neoplasms, and MART-1 antibodies are presumably recognizing an antigenic epitope in those steroidogenic proliferations, which is shared with the gplOO/PMel 17 molecules. 

Melan-A decorates adrenocortical carcinomas and sex-cord tumors of the ovary. 

TESTICULAR SEX CORD TUMORS Leydig Cell Tumor... 

Comperat E, Tissier F, Boye K, et al. Non-Leydig sex-cord tumors of the testis. The place of immunohistochemistry in diagnosis and prognosis. A study of twenty cases. Virchows Arch. 2004 444 567. 

Uterine Tumor Resembling Ovarian Sex Cord Tumor (UTROSCT)... 

Krishnamurthy S, Jungbluth AA, Busam KJ, et al. Uterine tumors resembling ovarian sex-cord tumors have an immunophe-notype consistent with true sex-cord differentiation. Am J Surg Pathol. 1998 22 1078-1082. 

Clement PB, Scully RE. Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of 14 cases. Am J Clin Pathol. 1976 66 512-525. 

The three major pathologic categories of ovarian tumors include sex-cord stromal, germ cell, and epithelial. About 85% to 90% of ovarian cancers are of epithelial origin. 

Ovarian sex cord-stromal tumors account for about 5% of all ovarian cancers and tend to be diagnosed at stage I. ° These tumors are associated with hormonal effects, such as precocious puberty, amenorrhea, and postmenopausal bleeding. 

Mostly Negative Germ cell tumors except choriocarcinoma, ovarian sex cord stromal tumors... 

Deavers MT, Malpica A, Liu J, et al. Ovarian sex cord-stromal tumors an immunohistochemical study including a comparison of calretinin and inhibin. Mod Pathol. 2003 16 584-590. 

Sasano H, Okamoto M, Mason JI, et al. Immunohistochemical studies of steroidogenic enzymes (aromatase, 17 alpha-hydroxylase and cholesterol side chain cleavage cytochrome P450) in sex cord stromal tumors of the ovary. Hum Pathol. 1989 20 452-457. 

McCluggage WG, Shanks JH, Whiteside C, et al. Immunohistochemical study of testicular sex cord-stromal tumors, including staining with anti-inhibin antibody. Am J Surg Pathol. 1998 22 615. 

Gordon MD, Gorless G, Renshaw AA, Beckstead J. CD99, keratin, and vimentin staining of sex cord-stromal tumors, normal ovary, and testis. Mod Pathol. 1998 11 769. 

Several endometrial stromal tumor variants have been described (Fig. 18.18). These include the smooth muscle variant (also referred to as mixed endometrial stromal and smooth muscle tumor or stromo-myoma), fibromyxoid variant,sex cord variant, and variants including endometrioid glands or epithelioid cells. The key to understanding the immunophenotype of these tumors is that variant or metaplastic elements often lose the phenotype of endometrial stroma and acquire the phenotype of the corresponding metaplastic element. Therefore, the smooth muscle in a smooth muscle variant of endometrial stromal nodule expresses muscle markers (Fig. 18.18B) and is frequently CD10-negative. T20 endometrioid... 

TABLE 18.7 Endometrioid Carcinoma vs. Sex Cord Stromal Tumors ... 

Tumors derived from the sex cords or ovarian mesenchyme compose 5% to 12% of all ovarian neo-plasms. 413 Benign tumors in the fibroma-thecoma group are relatively common. Other sex cord-stromal tumors and mesenchymal tumors are rare. The most common malignant sex cord- stromal tumor is granulosa cell tumor, which composes 1% of 2% of all malignant ovarian tumors. There are two types of granulosa cell tumors an adult type that occurs mainly in postmenopausal... 

Several antibodies have proven to be invaluable for the diagnosis of sex cord-stromal tumors. These include... 

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