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Ovarian Sertoli-Leydig cell tumors (SLCT) are rare in young women. They are divided into six categories based on the degree of differentiation and the presence of heterologous elements. Less than 15% of these tumors are poorly differentiated. A 14-year-old obese African-American girl presented with amenorrhea, progressive abdominal pain, and increasing abdominal girth. Pelvic CT revealed a 10 x 9 x 9 cm right adnexal mass which was resected successfully. The gross appearance was dark tan and red with central hemorrhage and necrosis. Microscopically, this was poorly differentiated with compact aggregates of moderate size oval to elongated cells separated by zones of edematous stroma containing scattered spindle shape cells. Areas of ill-formed tubules and primitive cords were present. Clusters of Leydig cells were observed. The oval and spindle cells showed multiple mitoses and were diffusely positive for inhibin and patchy but strong positivity for calretinin. Both preoperative and postoperative studies revealed no metastases. Serum alpha-fetal protein (AFP), androgen, and dihydroepiandrosterone sulfate (DHEA-S) were elevated.

It was a boys\\u2019 school, so on Kim\\u2019s orders 20 girls were brought in to make the Macias sisters more comfortable. Monica learnt Korean rapidly, but she was bewildered by the institution\\u2019s rigidity, its 5am reveilles followed by an hour\\u2019s exercise and the way her classmates asked permission to go to the lavatory. When she complained to a teacher, the tiny child was told, \\u201CRemember, you\\u2019re a soldier.\\u201D