# Sertoli cell tumor associated with ovarian sex cord tumor with annular tubules in a patient with 46 XY disorder of sex development and 9p24.3 deletion, case report

**Authors:** Tabatha Petrillo, Christian Battipaglia, Elisa Semprini, Cinzia Baldessari, Marta Pirola, Olga Calabrese, Antonino Farulla, Giliana Ternelli, Albino Eccher, Laura Botticelli, Alessandro D. Genazzani

PMC · DOI: 10.1111/jog.70027 · The Journal of Obstetrics and Gynaecology Research · 2025-08-01

## TL;DR

A 22-year-old patient with a 46 XY karyotype and a rare genetic deletion developed Sertoli cell tumors and a sex cord tumor, requiring surgery and close monitoring.

## Contribution

This case report highlights a rare association between 9p24.3 deletion and Sertoli cell tumors in a 46 XY disorder of sex development.

## Key findings

- The patient had a 1.24 Mb deletion on chromosome 9p24.3, including DMRT1, DMRT2, and DMRT3 genes.
- Histopathology confirmed bilateral Sertoli cell tumors and a sex cord tumor with annular tubules.
- No tumor recurrence was observed after 24 months of follow-up.

## Abstract

We report a rare case involving a 22‐year‐old phenotypically female patient who presented to our care with primary amenorrhea and spontaneous breast development. Hormonal analysis indicated hypergonadotropic hypogonadism, and imaging revealed a hypoplastic uterus and calcified ovaries. Karyotyping was 46, XY and the presence of the SRY gene was confirmed. The patient underwent laparoscopic bilateral salpingo‐oophorectomy due to the high risk of malignancy development. Histopathological analysis revealed bilateral Sertoli cell tumors and a sex cord tumor with annular tubules in the right gonad. Next generation sequencing genetic testing identified a 1.24 Mb deletion on chromosome 9p24.3, which included the DMRT1, DMRT2, and DMRT3 genes, as well as a partial deletion of KANK1. Hormonal replacement therapy was not initiated due to the potential risk of tumor recurrence, and follow‐up imaging was scheduled every 6 months for the first 2 years and then annually. No recurrence was observed at 24 months.

## Linked entities

- **Genes:** SRY (sex determining region Y) [NCBI Gene 6736], DMRT1 (doublesex and mab-3 related transcription factor 1) [NCBI Gene 1761], DMRT2 (doublesex and mab-3 related transcription factor 2) [NCBI Gene 10655], DMRT3 (doublesex and mab-3 related transcription factor 3) [NCBI Gene 58524], KANK1 (KN motif and ankyrin repeat domains 1) [NCBI Gene 23189]
- **Diseases:** disorder of sex development (MONDO:0002145), Sertoli cell tumor (MONDO:0002696)

## Full-text entities

- **Genes:** SRY (sex determining region Y) [NCBI Gene 6736] {aka SRXX1, SRXY1, TDF, TDY}, DMRT1 (doublesex and mab-3 related transcription factor 1) [NCBI Gene 1761] {aka CT154, DMT1}, MUC16 (mucin 16, cell surface associated) [NCBI Gene 94025] {aka CA125}, KANK1 (KN motif and ankyrin repeat domains 1) [NCBI Gene 23189] {aka ANKRD15, CPSQ2, KANK}, DMRT3 (doublesex and mab-3 related transcription factor 3) [NCBI Gene 58524] {aka DMRTA3}, NR5A1 (nuclear receptor subfamily 5 group A member 1) [NCBI Gene 2516] {aka AD4BP, ELP, FTZ1, FTZF1, POF7, SF-1}, FGF9 (fibroblast growth factor 9) [NCBI Gene 2254] {aka FGF-9, GAF, HBFG-9, HBGF-9, SYNS3}, WNT4 (Wnt family member 4) [NCBI Gene 54361] {aka SERKAL, WNT-4}, PRL (prolactin) [NCBI Gene 5617] {aka GHA1, pPRL}, SALL4 (spalt like transcription factor 4) [NCBI Gene 57167] {aka DRRS, HSAL4, IVIC, ZNF797}, SOX9 (SRY-box transcription factor 9) [NCBI Gene 6662] {aka CMD1, CMPD1, ENH13, SRA1, SRXX2, SRXY10}, MAP3K1 (mitogen-activated protein kinase kinase kinase 1) [NCBI Gene 4214] {aka MAPKKK1, MEKK, MEKK 1, MEKK1, SRXY6}, WT1 (WT1 transcription factor) [NCBI Gene 7490] {aka AWT1, GUD, NPHS4, WAGR, WIT-2, WT-1}, CALB2 (calbindin 2) [NCBI Gene 794] {aka CAB29, CAL2, CR}, AFP (alpha fetoprotein) [NCBI Gene 174] {aka AFPD, FETA, HPAFP}, MUC1 (mucin 1, cell surface associated) [NCBI Gene 4582] {aka ADMCKD, ADMCKD1, ADTKD2, CA 15-3, CD227, Ca15-3}, DMRT2 (doublesex and mab-3 related transcription factor 2) [NCBI Gene 10655] {aka DSXL-2, SCDO7}, MME (membrane metalloendopeptidase) [NCBI Gene 4311] {aka CALLA, CD10, CMT2T, NEP, SCA43, SFE}, AMH (anti-Mullerian hormone) [NCBI Gene 268] {aka MIF, MIS}
- **Diseases:** complete androgen insensitivity syndrome (MESH:D013734), congenital conditions (MESH:D002908), congenital defects (MESH:D000013), sex chromosome DSDs (MESH:D058533), bleeding (MESH:D006470), CAH (MESH:D047808), Mayer-Rokitansky-Kuster-Hauser syndrome (MESH:C537371), hypothyroidism (MESH:D007037), calcification (MESH:D002114), gonadoblastoma (MESH:D018238), Ovarian sex-cord stromal tumors (MESH:D010051), fibroma (MESH:D005350), hypergonadotropic hypogonadism (MESH:D007006), 46 XY DSDs (MESH:D058490), Alfi syndrome (MESH:D013577), SCTAT (MESH:D018312), Sertoli cell tumor (MESH:D012707), CGD (MESH:D006059), 9p deletion syndrome (MESH:C538024), tumorigenic (MESH:D002471), oncological diseases (MESH:D000072716), cell (MESH:D002292), granulosa and Sertoli cell tumors (MESH:D006106), malignancy (MESH:D009369), hypoplastic uterus (MESH:D014594), dysgerminoma (MESH:D004407), 46 XY DSD (MESH:D012734), 46, XY (MESH:C536769), 46 XY gonadal dysgenesis (MESH:D006061), malformations (MESH:C564254), craniofacial anomalies (MESH:D019465), metastases (MESH:D009362), primary amenorrhea (MESH:D000568), Turner syndrome (MESH:D014424), lymph node metastasis (MESH:D008207), PJS (MESH:D010580), intellectual disability (MESH:D008607), dysgenetic gonads (MESH:D006058), sclerosing fibroma (MESH:D012598), GCTs (MESH:D009373)
- **Chemicals:** fT3 (-), progesterone (MESH:D011374), Hematoxylin (MESH:D006416), testosterone (MESH:D013739), eosin (MESH:D004801), estradiol (MESH:D004958), H&amp;E (MESH:D006371)
- **Species:** Homo sapiens (human, species) [taxon 9606], Eurema lisa (little sulphur, species) [taxon 72258]

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## References

18 references — full list in the complete paper: https://tomesphere.com/paper/PMC12315508/full.md

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Source: https://tomesphere.com/paper/PMC12315508