Ovarian sex cord-stromal tumors with bizarre nuclei: a clinicopathologic analysis of 17 cases.

Seventeen ovarian sex cord-stromal tumors that contained bizarre nuclei are reported. The patients, two of whom were pregnant, ranged in age from 14 to 72 years (average, 47 years). The tumors, two of which had ruptured, were all Stage Ia. On microscopical examination, all the tumors had areas typical of one of the subtypes of ovarian sex cord-stromal tumors but, in addition, had foci where the cells had enlarged bizarre nuclei. Multinucleated giant cells were present in 12 cases and were of the floret-type in five of them. Apart from the presence of the bizarre nuclei and giant cells, the microscopical appearance and the mitotic rate of the tumors were similar to those of sex cord-stromal tumors in general. Eight tumors were classified as granulosa cell tumors, seven as Sertoli-Leydig cell tumors, and two as thecomas. Eleven patients who have been followed for 3-21 years (average, 9.7 years) postoperatively are alive and free of disease. Two patients have been lost to follow-up, and four have been treated too recently for a meaningful follow-up. The bizarre changes in these tumors resemble those seen in the uterine leiomyoma with bizarre nuclei and, like them, are probably degenerative. Their presence does not appear to alter the prognosis of the underlying tumor in view of the results of this small series.