Previous studies on neoplastic and hyperplastic ovarian lesions using
paraffin-embedded material have demonstrated immunolocalization of sex
steroid biosynthetic
enzymes (SSBEs): P-450 side chain cleavage (P-450 SCC), which converts
cholesterol to
pregnenolone;
3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), which converts
pregnenolone to
progesterone; P-450
17 alpha-hydroxylase and
lyase (P-450 17A), which convert
progesterone to
17 alpha-hydroxyprogesterone and
4-androstene-3,17-dione; and P-450
aromatase (P-450 AR), which converts
4-androstene-3,17-dione to
estradiol. To investigate the utility of immunohistochemical staining for SSBEs, we studied a series of 45
sex cord-stromal tumors of the ovary. P-450 SCC was present in 9 of 11 Sertoli-stromal cell
tumors, 3 of 12
granulosa cell tumors, 2 of 7
thecomas, and 1 of 1 stromal
luteomas; 3 beta-HSD was present in 5 of 11 Sertoli-stromal cell
tumors, 2 of 12
granulosa cell tumors, 2 of 7
thecomas, and 1 of 1 stromal
luteoma; P-450 17A was present in 5 of 11 Sertoli-stromal cell
tumors, 2 of 12
granulosa cell tumors, 2 of 6
thecomas, and 1 of 1 stromal
luteomas; P-450 AR was present in 6 of 11 Sertoli-stromal cell
tumors, 2 of 12
granulosa cell tumors, none of 7
thecomas, and 1 of 1 stromal
luteoma. SSBEs were not present in 12
fibromas, one sclerosing stromal
tumor, and one
myxoma. Five of 45 patients with
sex cord-stromal tumors showed androgenic effects; 4 of 11 patients with Sertoli-stromal cell
tumors and the patient with a stromal
luteoma. These five
sex cord-stromal tumors contained P-450 SCC, and three of four of the Sertoli-stromal cell
tumors contained 3 beta-HSD, P-450 17A, and P-450 AR. Concurrent endometrial histology was available in 25 of 45
sex cord-stromal tumor patients. None of the five
sex cord-stromal tumors arising in patients with endometria that showed
hyperplasia or
adenocarcinoma showed immunoreactivity for SSBEs. Eight patients' endometria were unremarkable, but their
sex cord-stromal tumor contained SSBEs. SSBEs were present in areas showing Leydig cell, Sertoli cell, or
steroid cell differentiation or luteinized areas; however, the results did not significantly add to the histologic classification of
sex-cord stromal tumors. Androgenic hormonal effects could always be explained by synthesis of
hormones by SSBEs present in the patient's
sex cord-stromal tumor.(ABSTRACT TRUNCATED AT 400 WORDS)