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Case of the Month



Steroid Cell Tumor, NOS

A 40 year old female presented with right ovarian mass. On gross examination the ovary measures 6.5 cm in maximum dimension with a tan/yellow cut surface. Histologic sections demonstrate bland tumor cells with abundant clear cytoplasm arranged into nests and sheets. Necrosis is not seen and rare mitotic figures are noted (0-1/10 HPF). Immunoperoxidase stains show that the tumor cells stain positive with Claretinin, Inhibin, and Vimentin (focal). No staining is seen with EMA, Desmin, PAX8, Melan A, PLAP, Oct 3-4, and CD10. The staining pattern and cytomorphologic features are most compatible with a Steroid Cell Tumor NOS.

Steroid Cell Tumors occur in adults with an average of 47 years. These tumors are often associated with virilization. Pathologic features of malignancy include tumor diameter > 7 cm, > 2 mitotic figures/10 HPF, necrosis, hemorrhage, and grade 2-3 nuclear atypia.