Atypical Ovarian Tumor: Mixed Sertoli–Leydig Cell Tumor of Retiform Variant with Focal Heterologous Elements

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BSTRACT

Ovarian torsion is an uncommon cause for acute abdominal pain in children while the possibility of malignancy presenting as ovarian torsion is even rarer. We report here an atypical case of ovarian neoplasm presenting as ovarian torsion in a 5-year-old child. The highlight of this case is the epithelial component staining positive for both CK 7 and CK 20 in addition to Sertoli–Leydig cell component indicating it as mixed Sertoli–Leydig cell tumor of retiform variant with focal heterologous elements. The heterologous element is the CK7 and 20 being positive epithelium. The ovarian torsion should make one suspect malignancy in and around the ovary and subject it for detailed histopathologic study and manage accordingly; lest, one’s failure to suspect the same may compromise patient management and prognosis.