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…mors are benign; however, their malignant potential is determined by their grade (see also Tumor Grade). Well-differentiated Sertoli-Leydig tumors usually behave in a benign manner, whereas poorly differentiated tumors tend to be malignant. In general, sex cord-stromal tumors are associated with hormonal effects such as virilization, the development of male secondary sex characteristics (e.g., a low voice, facial hair); precocious puberty, early sexual maturity; amenorrhea, absence/stopping of the menstrual period; or postmenopausal bleeding.