Sertoli-Leydig cell tumors of the ovary: review with emphasis on historical aspects and unusual variants.

Among the many contributions to gynecological pathology of Dr. Robert Meyer were his observations on Sertoli-Leydig cell tumors and the formulation of a classification of them that is the basis of the one used today. Selected variants in this category of tumors are reviewed here. Sertoli cell tumors are of interest clinically because, in contrast to other tumors in this category, they tend to be estrogenic rather than androgenic. They are important for the pathologist to be aware of, because other neoplasms of diverse types may mimic them. Heterologous Sertoli-Leydig cell tumors are noteworthy; since they may feature mucinous epithelium, carcinoid, skeletal muscle, and/or cartilage, they may present a confusing histologic picture that could result in a misdiagnosis. Similarly, the recently recognized retiform variant of Sertoli-Leydig cell tumor is apt to be misdiagnosed because its pattern of slit-like glandular spaces and papillae is often confused with tumors in the common epithelial category. These retiform lesions are also less often androgenic than are other Sertoli-Leydig cell tumors. Finally, neoplasms with bizarre nuclei and tumors that occur in pregnancy, which often have prominent intercellular edema, are briefly discussed.