Germline and somatic testing for ovarian Cancer: An SGO clinical practice statement.

Germline and somatic genetic testing have become critical components of care for people with ovarian cancer. The identification of germline and somatic pathogenic variants as well as homologous recombination deficiency can contribute to the prediction of treatment response, prognostic outcome, and suitability for targeted agents (e.g. poly (ADP-ribose) polymerase (PARP) inhibitors). Furthermore, identifying germline pathogenic variants can prompt cascade genetic testing for at-risk relatives. Despite the clinical benefits and consensus recommendations from several organizations calling for universal genetic testing in ovarian cancer, only about one third of patients complete germline or somatic genetic testing. The members of the Society of Gynecologic Oncology (SGO) Clinical Practice Committee have composed this statement to provide an overview of germline and somatic genetic testing for patients with epithelial ovarian cancer, focusing on available testing modalities and options for care delivery.

Ovarian Sertoli-Leydig cell tumors: a single institution experience and review of the literature.

Purpose ofinvestigation: Sertoli-Leydig cell tumors (SLCTs) of the ovary are rare, usually presenting as virilization in women in their second to third decade of life. Less than 10% of patients are older than age 50. The authors present a series of cases of SCLT managed at their institution. MATERIALS AND METHODS: A retrospective review was performed of all cases of ovarian SLCT diagnosed at a tertiary care institution between 1990-2014. Demographic data, clinical presentation, pathological findings, and treatment modalities were col- lected. RESULTS: Of the 16 patients diagnosed with SCLT over a 24-year period, nine patients (56%) were postmenopausal at the time of diagnosis, with a median age of 52.5 years (IQR = 39.7 years). These nine patients had a median interval of 14.7 years (IQR = 15) since the onset of menopause. Hyperandrogenism was a presenting feature in only five of 16 (31%) [median age of 49 (IQR= 26.5)] whereas postmenopausal bleeding was noted in two of 16 (12%). At diagnosis, tumor grade varied from well- to poorly-differentiated lesions, and eight patients (15%) received adjuvant chemotherapy. Disease-free survival over a median follow up of 31.5 months (IQR = 73.5 months) was 100% without recurrence. CONCLUSION: The present patient population was noticeably older than what has been described in literature, with the majority being postmenopausal. To the authors' knowledge, this is the largest series of postmenopausal patients with SLCT. Hyperandrogenism was evident in only a small sub-group. While the definitive management of SLCT remains controversial and varied, prognosis and risk of recurrence are reassuring.