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Table 2 Comparison of the clinical features between reported SCTs patients and current case

From: Ovarian steroid cell tumor causing isosexual pseudoprecocious puberty in a young girl: an instructive case and literature review

No.

Study

Age (yr)

IP/HP

Clinical presentation

Gonadal function

Uterine size (cm)

Tumor size (cm)

Pathology

Tx

RTc

Isosexual precocity

1

Present case

1

IP

Breast development

Nipples hyperpigmentation

Pubic hair growth

FSH < 0.1 IU/La

LH < 0.1 IU/La

E2 2420.9 pmol/La

3.57 × 1.47 × 1.96

4.2 × 2.5 × 1.4

Polygonal tumor cells with abundant cytoplasm ranging from vacuolated (lipid-rich) to eosinophilic (lipid-poor)

SO

5 months

2

Haroon et al., 2015 [4]

3

IP

Breast development

Vaginal bleeding

NA

NA

7.0

NA

SO

NA

3

Lin et al., 2000 [5]

3

IP

Breast development

Pubic hair growth

Vaginal bleeding

FSH < 1.0 IU/La

LH < 0.6 IU/La

E2 348.8 pmol/La

Testosterone 1.2 nmol/La

17-OHP 3.9 nmol/L

DHEA-S 3.1 μmol/L

6.2 × 3.2 × 2.2

4.4 × 4.1 × 3.2

NA

Resection of ovary

6 months

4

Lee et al., 2011 [6]

8

IP

Breast development

Pubic hair growth

Vaginal spotting

Hypertension

FSH < 0.1 IU/La

LH 0.29 IU/La

E2 1066.1 pmol/La

Aldosterone 2.3 nmol/L Angiotensin 124.0 pmol/L

NA

5.1 × 4.0

The ovarian tumor had sheets of clear or eosinophilic cells surrounded with a delicate fibrous stroma.

SO

16 months

Heterosexual precocity

5

Hellyanti et al., 2021 [7]

2

HP

Cushing’s syndrome

Virilization

Hypertension

Cortisol 733.89 nmol/L

Normal lutropin, gonadotropin and AFP

NA

5.0 × 4.2

×  3.5

The tumor comprised polygonal cells with distinct cellular borders and abundant, clear-to-granular eosinophilic cytoplasm.

SO

NA

6

Yoshimatsu et al., 2020 [8]

4

HP

Cushing’s syndrome

Virilization

Testosterone 8.4 nmol/Lb

ACTH 0.3 pmol/L

Cortisol 593.1 nmol/L

LDH 6.07 ukat/L

NSE 36.6 μg/L

NA

8.0 × 5.0 × 5.0

The tumor was composed of both eosinophilic and vacuolated cytoplasm.

SO and C/T

4 months

7

Qian et al., 2016 [9]

5

NA

Abdominal pain

Vomiting

AFP 1.15 μg/L

β-HCG < 0.10 IU/L

CA-125 37.71 kU/L

CA19–9 30.25 kU/L

NA

8.0 × 4.0 × 7.0

The tumor was composed of cells with abundant eosinophilic to clear cytoplasm and round nuclei with prominent nucleoli

SO and C/T

No recurrence within 5 years

8

Gupta et al., 2008 [10]

5

HP

Cushing’s syndrome

Facial acnes

Hirsutism

Hypertrichosis

E2 275.4 pmol/Lb

Testosterone 9.2 nmol/Lb

Progesterone 46.1 nmol/L

Cortisol 913.1 nmol/L

NA

NA

The cells had abundant eosinophilic cytoplasm and were strongly positive for inhibin immunostain.

Tumor excision

4 months

9

Sawathiparnich et al., 2009 [11]

6

HP

Cushing’s syndrome

Testosterone 1.9 nmol/Lb

ACTH 88.6 pmol/L

Cortisol 1073.9 nmol/L

DHEA-S 4.2 μmol/L

CA-125 95.68 kU/L

NSE 404.8 μg/L

NA

7 × 6 × 5

The ovarian tissue was replaced by nests or cords of round to polygonal cells with eosinophilic cytoplasm, mild nuclear atypia, and frequent intranuclear inclusions.

SO

8 months

10

Harris et al., 1991 [12]

8

HP

Virilization

NA

NA

NA

NA

Tumor excision

NA

11

Yılmaz-Ağladıoğlu et al., 2013 [13]

13

HP

Virilization

FSH 4.7 IU/La

LH 1.7 IU/La

E2 154.2 pmol/La

Testosterone 5.1 nmol/La

17-OHP 58.4 nmol/L

ACTH 1.6 pmol/L

DHEA-S 3.0 μmol/L

6.9 × 2.4 × 0.9

2.3 × 2.2

Moderately pleomorphic neoplasm without mitoses or necrosis, which was surrounded by a fibrous capsule with the intact surrounding ovarian tissue

SO

6 months

12

Boyraz et al., 2013 [14]

16

HP

Amenorrhea

Virilization

Testosterone 3.3 nmol/Lb

LDH 5.2 ukat/L

NA

6 × 4 × 3.3

Minor fibromatous component and areas of hyalinization were also present.

Ovarian cystectomy

4 months

13

Ding and Hsu., 2007 [15]

16

HP

Amenorrhea

Facial hirsutism

Temporal balding

Virilization

NA

NA

5.7 × 6.3 × 5.5

NA

Ovarian cystectomy

NA

14–16

Hayes and Scully, 1987 [2]

2–15 (3 case)

IP/HP

NA

NA

NA

NA

NA

NA

NA

  1. Abbreviation: 17-OHP 17α-OH Progesterone, ACTH Adrenocorticotropic hormone, AFP Alpha-fetoprotein, β-HCG β-subunit Human chorionic gonadostropin, C/T Chemotherapy, CA-125 Cancer antigen 125, CA19–9 Carbonhydrate antigen 19–9, DHEA-S Dehydroepiandrosterone sulfate, E2 Estradiol, FSH Follicle-stimulating hormone, HP Heterosexual precocity, IP Isosexual precocity, LDH Lactate dehydrogenase, LH Luteining hormone, NA Non-available, NSE Neuron Specific Enolase, SO Salpingo-oophorectomy, Tx Treatment
  2. aData via GnRH stimulation test
  3. bUnstimulated data
  4. cRT Remission time: define as the time from initial clinical symptoms to completely remission after operation