Work

Early-stage sertoliform endometrioid carcinoma of the ovary: diagnostic, molecular, and therapeutic considerations

Year: 2026

Type: article

Abstract: • Sertoliform variant of ovarian endometrioid carcinoma is extremely rare. • Dual CTNNB1 and FBXW7 mutations characterize a low-grade, indolent molecular profile. • Accurate diagnosis requires integration of morphology, immunohistochemistry, and molecular data. • Endocrine therapy was used as an individualized management approach in early-stage disease. • Long-term remission was observed with surgical resection and close surveillance over 3 years. The sertoliform variant of ovarian endometrioid carcinoma is exceedingly rare and often mimics sex-cord stromal or Brenner tumors, creating diagnostic challenges. Case A 72-year-old woman presented with progressive abdominal distention and pain. MRI revealed a 22.7 × 13.8 × 16 cm mixed cystic–solid pelvic mass with mild ascites and elevated tumor markers. She underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy. Pathology demonstrated low-grade endometrioid carcinoma, sertoliform variant, confined to the left ovary. Immunostains were positive for ER, AE1/AE3, β-catenin (nuclear/cytoplasmic), CDX2, and EMA. Molecular profiling revealed CTNNB1 (p.S33A) and FBXW7 (p.Q624*) pathogenic variants. She received adjuvant letrozole and remains disease-free at 3 years post-surgery. Conclusion This case highlights the diagnostic complexity of ovarian tumors with sertoliform morphology and the importance of integrating morphologic, immunohistochemical, and molecular data. When confined to the ovary, prognosis is excellent following surgical resection. Endocrine therapy may be considered on an individualized basis in hormone-responsive tumors, although its role in early-stage disease remains unproven.

Source: Gynecologic Oncology Reports

DOI: 10.1016/j.gore.2026.102025

Authors: Janhvi Sookram, Nisha Garg, Kevin B. Gilchrist

Institution: HonorHealth

Language: English

Topic: Ovarian cancer diagnosis and treatment

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $930