Giant Sertoli cell nodule of the testis: distinction from other Sertoli cell lesions (original) (raw)
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The sclerosing Sertoli cell tumor of the testis is an extremely rare entity
Therapeutic Advances in Urology
We present the case of a 31-year-old single male patient, who was admitted through emergency unit with painless hard nodule of his left testis of 6 months’ duration. Ultrasound scan of the scrotum showed a fairly well-defined hypo echoic area in the left testicular parenchyma in its middle part, measuring approximately 10 × 9 mm in size. We performed left inguinal radical orchidectomy. Histopathology examination of the left testis revealed sclerosing Sertoli cell tumor (SSCT) of the testis. This is a very rare testicular tumor with very few published case reports. Systemic examination was performed to exclude systemic metastasis. SSCT is characterized by the presence and aggregates of tubules of Sertoli cells, separated by a sclerotic intercellular matrix formed by fibrotic connective tissue.
Case Report of Misleading Features of a Rare Sertoli Cell Testicular Tumor
Medicina, 2019
Testicular Sertoli cell tumors are extremely rare. Generally, they are benign neoplasms, which belong to a group called sex cord–stromal tumors. In this article, we present a case report of a Sertoli cell tumor, which was accidentally discovered during a urological consultation of a 42-year-old male. An ultrasound showed a 2.1 × 2.2 cm hypoechogenic, hypervascular tumor in the middle third of the left testicle. Serum tumor markers (α-fetoprotein, alkaline phosphatase, β-human chorionic gonadotropin, and lactic dehydrogenase) were all within the normal range. Rapid microscopic evaluation of fresh frozen sections during the operation was inconclusive, which led to a decision not to perform a radical orchiectomy immediately. On formalin-fixed paraffin-embedded (FFPE) sections, the tumor histology showed atypical patterns, and immunohistochemical analysis was performed in order to determine the type of neoplasm and differentiate it from other types of testicular tumors, so as to assign ...
Journal of Clinical Pathology, 2004
To document the morphology, immunohistochemical staining properties, and ultrastructural features of hyaline material in Sertoli cell nodules of undescended testis and contrast them with those of sex cord tumour with annular tubules (SCTAT), which is histologically similar. To highlight the need to distinguish these nodules from other Sertoli cell hyperplasias, such as intratubular Sertoli cell proliferations, which occur in specific clinical contexts. A retrospective study of 46 orchidectomy specimens from cryptorchid testes, 27 of which contained Sertoli cell nodules. Special histochemical stains, immunohistochemical stains for type IV collagen and fibronectin, and ultrastructural examination of the hyaline material were performed using tissue from paraffin wax embedded tissue blocks. The hyaline deposits in SCTAT and Sertoli cell nodules had similar staining patterns-periodic acid Schiff (PAS) and PAS-diastase positivity with variable staining of Martius scarlet blue and Masson trichrome. Type IV collagen immunoreactivity was seen in hyaline areas, although fibronectin was negative. Electron microscopy of hyaline areas confirmed a compact matrix identical to components of the basement membrane in the adjacent seminiferous tubules. This study describes an unusual form of Sertoli cell proliferation in undescended testes, which must be distinguished from Sertoli cell tumours and other forms of proliferation. In addition, the hyaline material within Sertoli cell nodules in the cryptorchid testis is histochemically, immunohistochemically, and ultrastructurally consistent with both matrix and fibrous components of seminiferous tubule basement membranes. Increased production of basement membrane material, with subsequent invagination into tubules, is the most likely origin of this material.
Large-cell calcifying Sertoli cell tumour of the testis: Associated organ anomalies
Journal of Medical Imaging and Radiation Oncology, 1999
tance pattern which includes cardiac myxomas, cutaneous myxomas, myxoid mammary fi bro-adenomas, spotty skin pigmentation, pigmented nodular adrenocortical disease, testicular tumours, and pituitary adenoma producing gigantism or acromegaly [3]. Carney syndrome can be tentatively diagnosed in the presence of two of the above components, and a defi nitive diagnosis is warranted in the presence of three components [3]. Case Report A 34-year-old male was called up for screening due to the detection of Carney syndrome in his 18-year-old niece who suffered a stroke due to a cardiac myxoma. He gave a history of multiple skin nodules since childhood which recurred after excision. On examination, a right-sided hard, irregular testicular mass was detected. The patient had known of its presence for about 7 years, but ignored it. A right orchiectomy was done. The excised specimen consisted of a well-circumscribed tumour measuring 60 ! 50 ! 30 mm with multiple lobules of calcifi ed tissue interspersed with yellowish fl eshy areas without any necrosis or haemorrhage. Microscopic examination revealed trabeculae and small nests of large cells with abundant eosinophilic cytoplasm (fi g. 1). The trabeculae were separated by abundant fi brous stroma containing large areas of laminated calcifi cation (fi g. 2). The mitotic count was 9 in ten high-power microscopic fi elds. There was no invasion of the tunica vaginalis or the spermatic cord. The histological appearance was compatible with that of a LCCSCT. The left testis was normal. A two-dimensional echocardiogram was also performed
Testicular sclerosing Sertoli cell tumor: an additional case and review of the literature
Anticancer research, 2012
Sertoli cell tumours are very rare testicular tumours accounting for 0.4-1.5% of all testicular neoplasms. In the current report, we present a case of sclerosing Sertoli cell tumour. The histology and clinical features were compared to those of other Sertoli cell tumour subtypes in order to assess if the different subtypes really represent distinct clinical and prognostic entities. The current literature was also reviewed. Only 20 cases of sclerosing Sertoli cell tumours have been encountered. Our case, a 38-year-old man represents the 21st case. Distinction among Sertoli cell tumours is important not only histologically; sclerosing Sertoli cell tumours have a distinct clinical behaviour and prognosis, different from those of classic and large-cell calcifying Sertoli cell tumours. Pathologists and urologists should know and understand all the types of Sertoli cell tumours in order to be able to choose the correct therapeutical approach when they encounter these tumours.
Malignant (androblastoma) sertoli cell tumor of testes
Urology, 1981
Sertoli cell tumor of the testis is rare. Of those reported only 10 per cent are malignant. An additional malignant Sertoli cell tumor is reported with a discussion of the pathological aspects and a review of the literature. Androblastomas (Sertoli cell tumors) are rare. Their occurrence rate is estimated to be 0.4 per cent of all testicular neoplasms. 1 These tumors are usually slow growing. Initially they were thought to be benign. Of the 68 reported cases 7 were associated with metastases. An additional case of metastasizing Sertoli cell tumor and a review of the literature are reported herein. CASE REPORT A 60-year-old white man was admitted to the hospital on September 21, 1971. One month prior to hospitalization the patient had an episode of dull, right lower quadrant pain. When the pain recurred the patient saw his family physician. A right testicular mass was discovered and he was admitted to the hospital. Bilateral mumps orchitis in late childhood had resulted in bilateral testicular atrophy. The patient was known to be sterile. Bilateral gynecomastia had been present for several years. Physical examination revealed scanty facial, axillary and pubic hair but a deep voice. There was moderate bilateral gynecomastia. The left testis was atrophic. The right testis was enlarged, ovoid and hard. There were no palpable inguinal nodes. Urinalysis, complete blood count, liver function tests, chest x-ray and an excretory urogram (IVP) were normal. A preoperative test for urinary choriogonadotropin was negative. On September 23 a right inguinal orchiectomy was performed. Pathological examination suggested teratocarcinoma initially but the final pathologic diagnosis was Sertoli cell tumor. A retroperitoneal node dissection was performed on September 29. The right testis measured 6 by 6 cm. The attached cord was 10 cm. long. Sections of the testis revealed a 3 by 3 by 2 cm. yellow-tan, pseudoencapsulated, central mass replacing most
Sclerosing Sertoli Cell Tumor of the Testis
The American Journal of Surgical Pathology, 1991
Sclerosing Sertoli cell tumor (SSCT) of the testis is rare, with only 22 previously reported cases. Most have been small, circumscribed masses, and none has had a malignant clinical course; however, follow-up is limited. We have examined 20 new SSCTs to better characterize their features and report long-term follow-up. At least focal tubule formation by sex cord cells in a dense, hypocellular fibrous stroma occupying at least 50% of the lesion was required. The patient age ranged from 23 to 52 years (mean, 37; median, 39). All SSCTs were unilateral with 11 left sided and 9 right sided. The average size was 1.7 cm (range, 0.5 to 6 cm). In most cases, the stroma represented 50% to 70% of the mass but was at least 80% in 2. The Sertoli cells formed cords, trabeculae, small nests, focal tubules (sometimes with a vague pseudovascular or retiform appearance), and rarely single cells. Most tumor cells had small, round, oval to polygonal nuclei with finely granular chromatin, small nucleoli, and modest amounts of pale, eosinophilic cytoplasm. No mitotic figures, significant atypia, or necrosis was seen. All tumors but 1 were circumscribed and lacked lymphovascular invasion. Followup in 15 patients (3 mo to 16 y; mean, 6.1 y) showed 9 alive and free of disease, 5 alive with unknown disease status, and 1 patient, who presented with bone metastases, dead of disease at 27 months. The only features in the malignant case that differed from all others in our study were lymphovascular invasion and lack of circumscription. Combining our cases with previously reported ones shows that SSCTs are unilateral, usually small (80% <2 cm) tumors that occur in a wide age range (18 to 80 y old; mean, 35 y) and lack necrosis. Only 1 of 31 with follow-up (mean, 4.4 y) metastasized; this tumor was 3.8 cm and had lymphovascular invasion and invasive growth. We conclude that SSCTs<2 cm with the typical features and lacking those associated with malignancy in Sertoli cell tumors, not otherwise specified, have a negligible risk of metastasis and are adequately managed by orchiectomy alone.
Pathology International, 2003
A 19-year-old man with mild mental retardation was diagnosed as having metastatic choriocarcinoma and a testicular tumor. Histopathological examination of the resected testis revealed the presence of a small lesion of mature teratoma but no trace of choriocarcinoma. The remaining seminiferous tubules were atrophic and lined by large atypical germ cells, which were diagnosed as intratubular germ cell neoplasia of the unclassified type (IGCNU). A small area with prominent tubules was also observed. Within this lesion, the tubules were dilated and contained several layers of cells with central necrosis. Immunohistological comparison of staining for several biological markers (Ki-67, c-kit and placental alkaline phosphatase) between cells in the atrophic tubules and those in the dilated tubules indicated a progression of the latter cells to cells with a more proliferative ability. In the opposite testis, examined at autopsy after death due to metastatic choriocarcinoma, all seminiferous tubules were lined by Sertoli cells only. It was therefore assumed that the germ cell tumor of the combined histological type had primarily arisen in the background of IGCNU, and that choriocarcinoma had spontaneously regressed. The early onset of these testicular neoplastic lesions strongly indicates their occurrence under the genetic background of gonadal dysplasia, the Sertoli cellonly syndrome. The possible relation of gonadal disease to mental retardation in this patient is also discussed.
Magnetic resonance imaging findings of sclerosing Sertoli cell tumor of the testis
Japanese journal of radiology, 2013
We present a case of sclerosing Sertoli cell tumor of the testis that was examined preoperatively by magnetic resonance imaging. A 28-year-old male presented to the urology department of our hospital complaining of a painless mass in the right testicle that had been present for the past 2 years. Levels of the tumor markers AFP, hCG, and LDH were all within the standard ranges. T2-weighted MR images showed a well-demarcated lobular hypointensity 15 mm in size in the right testis. Contrast enhancement of this mass after gadolinium administration was homogeneous, with slightly stronger enhancement than the normal testis tissue. Tumor enucleation was performed, and the tumor was diagnosed as a sclerosing Sertoli cell tumor.