Sex cord-stromal tumors, also known as sex cord-gonadal stromal tumors, develop in the ovaries and testes.
This group of tumors is responsible for just under 5% of testicular cancers, as well as 8% of ovarian cancers. 70% of patients with sex cord-stromal tumors are in stage I of tumor development, which often leads to a positive prognosis.
Sex cord-stromal tumors include:
- Granulosa Cell Tumors
- Thecoma
- Sertoli-Leydig Cell Tumors
- Sertoli Cell Tumors
- Leydig Cell Tumors
- Fibroma
- Fibrosarcoma
- Sclerosing stromal tumors
Of these, the most common are granulosa cell tumors and Sertoli-Leydig cell tumors. 15,000-20,000 cases of sex cord-stromal tumours are diagnosed every year in the United States.
Signs and Symptoms (Pathophysiology)
Symptoms of sex cord-stromal tumors vary depending on the type of tumor (see above).
Symptoms may include:
- Back Pain
- Abdominal Swelling or Bloating
- Feeling Full
- Fatigue
- Pelvic or Abdominal Pain
- Constipation
- Upset Stomach
- Frequent Need to Urinate
- Menstrual Irregularities
- Pain During Sex
Symptoms often go undetected until late development.
Diagnosis and Staging
An exact diagnosis can only be made with a biopsy (the removal of cell groups and/or tissues). A histological examination is performed following the biopsy, which is also critical in securing a proper diagnosis and a positive prognosis.
In the future, physicians hope to diagnose sex-cord stromal tumors using magnetic resonance imaging (MRI). MRI is non-invasive, whereas biopsy requires a needle and syringe, or an incision.
Treatment
The removal of sex cord-stromal tumors is conducted through surgery. The type of surgery varies, usually depending on age; for example, young women may be treated through a bilateral salpingo-oophorectomy (the removal of the fallopian tubes and ovaries). In older women, treatment can also include a complete hysterectomy (the removal of the uterus). Localized tumors may also be treated with Chemotherapy and Radiation.
Outlook (Prognosis)
Prognosis is typically positive. Depending on the type of tumor, survival rates are between 90 and 100% in early stages. The mortality rate for patients with juvenile granulosa cell tumors, for example, is less than 2%.
As with most cancers, survival rates drastically decrease with late-stage diagnoses. Patients with advanced stages of granulosa cell tumours, for instance, have only a 25 to 50% 5-year survival rate.
