Background. Sertoli-Leydig cell tumors belong to the group of sex cord stromal tumors of the ovary. They account for less than 0.5 % of all ovarian tumors and occur primarily in young women between ...20 and 30 years of age. This type of tumors can secrete androgens, causing virilisation, and are extremely rarely presented in postmenopausis. Methods. A 73-year old multiparous woman was presented to our institution with complaints of abdominal distention and abdominal pain in her lower abdomen. On physical examination, she had a large, fixed palpable abdominal mass, approximately 20 cm in diameter, arising from the pelvis. The laboratoric tests revealed an elevated level of CA125 of 221.3 U/ml of serum. The ultrasound showed a complex cystic and solid pelvic tumor. There was no sign of ascites. Her hormonal status was within normal range and she also showed no signs of virilisation. On laparotomy a complex left ovarian mass, measuring 30 × 27 × 15 cm was found and sent to frozen section. The result of frozen section was a malignant tumor of unknown origin, therefore a radical surgical procedure was performed. The histopathological examination established the diagnosis of a malignant Sertoli-Leydig cell tumor of the left ovary, of intermediate differentiation. Other removed tissue was free of malignant cells. The early postoperative course was uneventful and the patient was released from hospital 10 days after surgery. However, she returned to our institution 16 days after surgery due to a proximal thrombosis of v. saphena magna. The patient was treated with low-molecularweight heparin and later warfarin for 6 weeks post operation. 16 months after the operation she was symptomatically treated for severe microcytic anemia. She showed no signs of a relapse. 27 months after primary surgery she was operated for the second time due to acute bowel obstruction. She had large masses of necrotic tumor removed from abdomen and transversostomia was performed. It was found to be a relapse of the malignant Sertoli-Leydig tumor, infiltrating the small intestines; the level of serum CA 125 also showed an increase. Conclusions. We describe a case of a Sertoli-Leydig cell tumor in a postmenopausal woman, treated in our institution.
ABSTRACT Introduction The main objective was to assess the impact of the COVID-19 pandemic on vitamin D supplementation habits and their changes in the follow-up, 20 months after the study in ...Slovenian premenopausal and postmenopausal women. Methods A cross-sectional study was conducted between March and May 2021. 176 healthy women aged 44 to 65 from the Central Slovenian region were included in the final analysis. Vitamin D status was determined by measuring 25(OH)D concentration. After 20 months an online follow-up questionnaire was sent out, to which 123 participants responded with complete data. Results Between March and May 2021, 61% of the participants were supplementing vitamin D. 55% of the supplementers and 88% of the non-supplementers had insufficient levels (total 25(OH)D <75 nmol/L). After 20 months in the follow-up, it was found that 62% of participants were taking vitamin D supplements, but only 70% of those who had initially reported taking supplements were still doing so. In the follow-up 61% of participants stated that they started or increased vitamin D intake due to COVID-19. Conclusions Vitamin D supplementation increased 7-fold compared to pre-pandemic levels and remained at a high level after 20 months. However, a significant number of participants discontinued supplementation, and only one-fifth were taking vitamin D throughout the entire year. Supplementation is effective for vitamin D deficiency prevention only at the individual level, however due to low compliance it should not be the only strategy for preventing vitamin D deficiency in the population.
