Invasive breast carcinoma - IARC

mitotic rate may be present in these
t u m o u r s .
Stromal-Leydig cell tumour
Definition
An ovarian stromal tumour composed of
f i b romatous stroma and clusters of
Leydig cells containing crystals of
R e i n k e .
Clinical features
This tumour is virilizing in appro x i m a t e l y
one-half of the cases.
M a c r o s c o p y
These extremely rare neoplasms are usually
well circumscribed {302,2165,2842}.
The sectioned surface has been
described as lobulated with a yellowwhite
appearance. They may be bilateral.
H i s t o p a t h o l o g y
S t romal-Leydig cell tumours have two
components. Spindle-shaped or ovoid
s t romal cells identical to those of a fibroma
or thecoma are present together with
Leydig cells containing Reinke cry s t a l s
{2789,3252}. Ty p i c a l l y, in these neoplasms
the fibrothecomatous element
p redominates with the Leydig cell component
comprising small nodular aggreg
a t e s .
Definitive diagnosis re q u i res the pre s-
ence of Reinke crystals, otherwise the
neoplasm would be categorized as
luteinized thecoma. Since Reinke cry s-
tals may be difficult to identify and since
sampling errors may occur, it has been
suggested that stromal-Leydig cell
tumours are more common than the lite
r a t u re would suggest.
Prognosis and predictive factors
The clinical behaviour of stro m a l - L e y d i g
cell tumours is benign, and neither clinical
re c u r rence nor metastasis has been
d o c u m e n t e d .
Sex cord-stromal tumours
of mixed or unclassified
cell types
D e f i n i t i o n
Sex cord - s t romal tumours that do not fall
in the granulosa-stromal, Sert o l i - s t ro m a l
or steroid cell categories.
ICD-O codes
Sex cord tumour with annular
t u b u l e s 8 6 2 3 / 1
Variant associated with
Peutz-Jeghers syndrome 8 6 2 3 / 0
G y n a n d ro b l a s t o m a 8 6 3 2 / 1
Sex cord - s t romal tumour, NOS 8 5 9 0 / 1
Sex cord tumour with
annular tubules
D e f i n i t i o n
A tumour composed of sex cord (Sert o l i )
cells arranged in simple and complex
annular tubules {2599}.
S y n o n y m
S e rtoli cell tumour, annular tubular varia
n t .
E p i d e m i o l o g y
Patients with this tumour most commonly
present in the third or fourth decades,
but the age ranges from 4-76 years.
About one-third of cases occur in women
with Peutz-Jeghers syndrome (PJS). The
average age of patients with PJS is in the
mid-twenties and of those unassociated
with PJS in the mid-thirties.
Clinical features
Nearly all women without PJS pre s e n t
with a palpable mass. Isosexual
p s e u d o p recocity or other features of
aberrant estrogen occurs in about 40%
of cases, and, occasionally, there are
p ro g e s t e rone effects. Those tumours
that are associated with PJS are found
either incidentally at autopsy or in
ovaries removed as part of treatment for
other gynaecological disease.
M a c r o s c o p y
These are unilateral neoplasms except
for those occurring in the PJS, which are
usually bilateral. PJS-associated lesions
a re usually macroscopically undetectable;
when visible, the tumourlets
a re multiple and