[Coexistence of sertolioma with borderline (adenoma-cystoma-fibroma) tumor in the ovaries of a 69 year old patient]

A rare case of coexistence of gonadal neoplasm Sertolioma with boundary line tumor with epithelial fill in ovaries in 69 old patient was described. Current diagnostic and prognostic possibilities in such cases were discussed.

Utility of immunohistochemistry in distinguishing ovarian sertoli-stromal cell tumors from carcinosarcomas

Poorly differentiated Sertoli-stromal cell tumors and carcinosarcomas of the ovary both show biphasic epithelial and stromal patterns and may both show heterologous stromal elements, presenting a difficult diagnosis. We studied the immunohistochemical profile of Sertoli cell differentiation in human testes and applied these findings to the ovarian tumors. Eleven Sertoli-stromal cell tumors, six carcinosarcomas of the ovary, and 11 testes (six fetal, one infant, and four adult) were studied using antibodies to cytokeratin AE1:AE3 (AE1:3), cytokeratin CAM 5.2 (CAM), epithelial membrane antigen (EMA), vimentin, desmin, muscle-specific actin (MSA), S-100 protein (S-100), CA 19-9, CA 125, carcinoembryonic antigen monoclonal (CEA-M), carcinoembryonic antigen polyclonal (CEA-P), and placental alkaline phosphatase (PLAP). In the fetal testes, immature gonadal stroma and sex cord areas stained with vimentin (six of six cases), AE1:3 (five of six cases), and CAM (six of six cases). Sertoli cells in immature gonadal stroma areas, sex cords, and seminiferous tubules of normal fetal, infant, or adult testes never showed immunoreactivity for EMA, S-100, CA 19-9, CA 125, CEA-M, CEA-P, or PLAP. All Sertoli-stromal cell tumors stained with AE1:3 and CAM in areas of Sertoli cell differentiation (11 of 11 cases) but did not stain with EMA, PLAP, CEA-P, CEA-M, CA 19-9, CA 125, or S-100 (none of 11 cases). Carcinosarcomas expressed AE1:3 and CAM in all epithelial areas (six of six cases) and most stromal areas (five of six cases). Carcinomatous areas of carcinosarcoma also showed immunoreactivity for EMA (six of six cases), CA 125 (two of six cases), PLAP (two of six cases), CEA-P (two of six cases), and CEA-M (one of six cases), while stromal areas of carcinosarcoma expressed EMA (four of six cases) and S-100 (four of six cases). Heterologous stromal elements were present in three of 11 Sertoli-stromal cell tumors (two showed skeletal muscle and one showed both skeletal muscle and cartilage differentiation) and in four of six carcinosarcomas (one skeletal muscle, one cartilage, and two cartilage and skeletal muscle). All skeletal muscle heterologous elements expressed desmin, vimentin, and MSA. The heterologous cartilage in carcinosarcoma stained with S-100 (three of three), while the one case of heterologous cartilage in Sertoli-stromal cell tumor did not. These results suggest that ovarian Sertoli-stromal cell tumor can be distinguished from carcinosarcoma by the absence of staining for EMA, PLAP, CEA, CA 125, or CA 19-9 in epithelial areas of Sertoli-stromal cell tumor.(ABSTRACT TRUNCATED AT 400 WORDS)

Fine needle aspiration cytology in malignant Sertoli cell tumor of the testis. A case report

A rare case of malignant Sertoli cell tumor of the testis occurred in which the diagnosis was initially suggested on fine needle aspiration cytology. Smears of the testicular, inguinal and cervical lymph node aspirates showed cells resembling normal Sertoli cells arranged in nests and tubules. Histopathology of the orchidectomy specimen confirmed the diagnosis. The literature is briefly reviewed.

Ovarian sex cord tumor with annular tubules--a case report and review of the literature in Japanese

A case of ovarian sex cord tumor with annular tubules (SCTAT) in a 41-year-old female is reported. The patient's chief complaint was menstrual irregularity, but the serum values of estradiol and testosterone were not elevated. On gross examination, the left ovary measured 8 x 7 x 6 cm in size and its cut surface was yellowish gray or yellow and solid with no cystic area. Histologically, the tumor was composed of simple and complex annular tubules, lined by columnar cells containing abundant lipid droplets. Eosinophilic materials in the center of the annular tubules were continuous with the basement membrane in the periphery, and showed immunoreactivity for type IV collagen. Also, hollow tubules, consisting of columnar cells with a truncated luminal surface and elongated trabeculae, composed of columnar cells with clear cytoplasm, were noted. These structures were reminiscent of Sertoli cell tumor. Based on these histological observations, it appears that SCTAT is a sex cord/stromal tumor made up of cells with differentiation in the direction of Sertoli cells rather than granulosa cells.

Sertoli-Leydig cell tumor of the ovary: a rare cause of amenorrhea

A 15-year-old girl presented to a primary care clinic with secondary amenorrhea, masculinization, and rapidly increasing abdominal girth. Evaluation revealed a large pelvic mass, which was found at laparotomy to be a bilateral Sertoli-Leydig cell tumor producing androgens and high levels of alpha-fetoprotein (AFP). The patient underwent bilateral salpingo-oophorectomy. Other pelvic structures were uninvolved. The postoperative course was unremarkable, with testosterone and AFP levels in the normal range. A thorough literature search revealed no cases in which bilateral Sertoli-Leydig cell tumors were associated with high AFP levels. This case was unusual in its pathology, dramatic in its presentation, and valuable in its implications regarding the work-up of amenorrhea in young women.

Multiple lentigines, myxoid tumours and endocrine overactivity; four cases of Carney's complex

Four patients with Carney's complex, one sporadic and three familial, are described. The sporadic case was a young male with centrofacial lentigines, who developed cyclical Cushing's syndrome secondary to bilateral pigmented nodular adrenocortical disease, two separate left atrial myxomas, and buccal mucosal myxomas. The three familial cases, who all had varying degrees of centrofacial/mucosal lentigines and cutaneous myxoid tumours, were a woman with myxoid mammary fibroadenomatosis and a left atrial myxoma, her daughter who developed a prolactin-secreting pituitary adenoma, and her son who had bilateral large-cell calcified Sertoli cell testicular tumours, and an axillary psammomatous melanotic schwannoma.

Testicular sex cord-stromal lesions: immunohistochemical analysis of cytokeratin, vimentin and steroidogenic enzymes

We have studied immunolocalization of all steroidogenic enzyme involved in sex steroids biosynthesis, P-450 side chain cleavage (P-450scc), 3 beta hydroxy steroid dehydrogenase (3 beta-HSD), P-450 17 alpha hydroxylase (P-450(17 alpha)) and P-450 aromatase (P-450arom) and that of vimentin and cytokeratin in 14 cases of testicular sex cord-stromal tumours (6 Leydig cell tumours, 5 Sertoli cell tumours, 2 fibromas and 1 granulosa cell tumour) as well as 4 cases of hyperplasia (2 Leydig and 2 Sertoli). Leydig cell tumour expressed all four steroidogenic enzymes examined, indicating that this tumour can synthesize oestrogen from cholesterol. In 2 cases of Sertoli cell tumour, the tumour cells with clear cytoplasm and without Reinke's crystals expressed P-450ssc, 3 beta-HSD and P-450(17 alpha), suggesting the capability of androgen production in these tumour cells. Fibromas and granulosa cell tumour were negative for the enzymes examined. In immunohistochemistry of intermediate filaments, Leydig cell tumours demonstrated only vimentin. Sertoli cells in hyperplasia and non-neoplastic testis expressed only vimentin but Sertoli cell tumours expressed both cytokeratin and vimentin. Cytokeratin immunoreactivity was correlated with morphological epithelial differentiation in Sertoli cell tumour. These findings in testicular Sertoli cell tumour are considered to represent the multiple differentiation capacity of this neoplasm. Immunohistochemical study of steroidogenic enzymes and intermediate filaments provided new insight into neoplastic steroidogenesis and the differentiation capacity of testicular sex cord-stromal neoplasms.

Peritoneal cytology of uncommon ovarian tumors

Peritoneal cytology has been well established as a diagnostic and staging tool in the management of the common epithelial tumors of ovary. Germ cell, mesenchymal, and sex-cord stromal tumors are much less frequently encountered in peritoneal specimens, often with cytologic features that may pose problems in differential diagnosis. This report presents the cytomorphology of the ascitic fluid in cases of endodermal sinus tumor, dysgerminoma, and Sertoli-Leydig-cell tumor, and peritoneal washings in a case of ovarian malignant mixed mullerian tumor. The cytologic features of Sertoli-Leydig-cell tumors have not been well described. Careful correlation of peritoneal cytologic findings, cell-block preparations, and immunocytochemistry with the cytohistologic features of these tumors is crucial for correct tumor classification.

[Sertoli-Leydig-cell ovarian tumor with a retiform pattern and heterologous elements: a rare cause of virilization]

The case is presented of a young female with virilization signs and total circulating testosterone levels above 4 ng/ml, without a concomitant increase in cortisol, 17 OH-progesterone, DHEA-S, or androstenedion levels. On CT scan exam a tumoral mass in the left ovary was observed with polycystic characteristics similar to those observed in ovarian cystadenoma, inspite of the fact that most androgenic ovarian tumors are solid. The pathological study revealed an ovarian Sertoli-Leydig tumor associated to a reticular pattern with heterologous chondroid and mucinoid elements of cystadenoma.

Lectin histochemistry of sex cord-stromal tumors and small cell carcinoma of the ovaries

Binding sites of peanut agglutinin (PNA), Ulex europaeus (UEA-1), concanavalin A (Con A), and wheat germ agglutinin (WGA) were localized in 10 granulosa cell tumors, 10 Sertoli-Leydig cell tumors, 4 theca cell tumors, and 5 small cell carcinomas. Con A and WGA reacted positively with the majority of the studied neoplasms. PNA and UEA-1 were persistently negative in the sex cord-stromal tumors (SCST) but showed focal positivity in small cell carcinomas. Negative reactions of SCST with PNA and UEA-1 may serve for differentiation between them and common epithelial tumors that are usually PNA and UEA-1 positive.

Large cell calcifying Sertoli cell tumor of the testis

We report on a patient with a large cell calcifying Sertoli cell tumor of the testis and review the literature of this recently described rare subtype of Sertoli cell tumor. Twenty-one cases, including ours, have been reported in the literature. Six of twenty cases (28%) had clinically evident endocrine abnormalities and eight of twenty-one cases (38%) were bilateral. This tumor has a low malignant potential with only one patient known to have metastatic disease.

Large cell calcifying Sertoli cell tumor of the testis. A clinicopathologic, immunohistochemical, and ultrastructural study of two cases

The clinicopathologic, immunohistochemical, and electron microscopic study of two patients with large cell calcifying Sertoli cell tumors (LCCSCT) of the testis is reported to elucidate the histogenesis of this rare tumor. Both tumors occurred in young individuals (16 and 32 years); case 1 was found incidentally, and the patient in case 2 presented with a 3-4-week history of testicular pain. Evidence of testosterone production was demonstrated in one case. In the same case, at the ultrastructural level Charcot-Böttcher crystalloids were observed. These data support previous reports that LCCSCT shows Sertoli cell differentiation.

Sclerosing Sertoli cell tumor of the testis. A report of 10 cases

Sex cord-stromal tumors of the testis are uncommon and have been less well characterized than similar tumors of the ovary, with a much greater proportion of them falling into the "unclassified" category. We report the clinical and pathological features of 10 Sertoli cell tumors of the testis with prominent sclerosis, representing a distinctive, heretofore undescribed subtype of Sertoli cell tumor in the human. The patients were mostly in their 3rd and 4th decades (median age, 30 years; range, 18-80 years). One tumor occurred in a cryptorchid testis, and one patient had had an orchidopexy several years prior to his presentation. There was no evidence of estrogen production by the tumor in any case. The tumors occurred equally often in each testis and were small (0.4-1.5 cm) in diameter, except for two tumors, which were 4.0 cm in diameter. All of them were centered in the testicular parenchyma and were well-demarcated, hard, yellow-white to tan nodules. They were characterized histologically by solid and hollow, simple and anastamosing tubules, large irregular aggregates, and thin cords of Sertoli cells in a prominent collagenous background. The tumor cells were of medium size and had pale cytoplasm, which sometimes contained large lipid vacuoles; the round nuclei varied from small and dark to large and vesicular. Follow-up information on five patients--including the only one whose tumor had malignant features histologically--showed no evidence of recurrence or metastasis 3-10 years (mean, 5.8 years) after orchidectomy alone.

The androgen insensitivity syndrome (testicular feminization): a clinicopathologic study of 43 cases

Forty-three patients with the androgen insensitivity syndrome (AIS), ages 14 to 83 (average 27) years, were studied. Forty patients had complete AIS and three patients had incomplete AIS. Microscopic examination of the testes revealed immature tubules, which contained rare spermatogonia in 28% of the cases. Prominent Leydig cells and a spindle-cell stroma resembling ovarian stroma were found in a majority of cases. The organization of the testicular parenchyma could be classified into one of four patterns: diffuse tubulostromal, lobular tubulostromal, mixed tubulostromal, or stromal-predominant. Hamartomas were present in 63% and Sertoli cell adenomas in 23% of the cases. Malignant tumors developed in 9% of the patients and comprised two seminomas, one intratubular germ cell neoplasm with early stromal invasion, and a malignant sex cord tumor. At least one fallopian tube was present in 35% of the cases.

Ollier's disease associated with ovarian Sertoli-Leydig cell tumor and breast adenoma

An ovarian Sertoli-Leydig cell tumor in a 15-year-old girl is reported. The patient had enchondromatosis (Ollier's disease), and a review of the literature revealed a few previous reports linking enchondromatosis with ovarian sex-cord stromal tumors. This association between these two unusual lesions indirectly supports a generalized mesodermal dysplasia in patients with enchondromatosis.

Malignant Sertoli and Leydig cell tumour in a boar

A rare case of Sertoli and Leydig cell tumour was investigated in a 6-month-old boar. The neoplasm was found in the right testis and had metastasized to the liver, spleen, kidneys and diaphragmatic peritoneum. Metastatic nodules were also present in the tissues near the right testis and some neoplastic cells were present in the superficial inguinal lymph node. The neoplastic cells exhibiting severe pleomorphism were divided into Sertoli and Leydig cell types, although in some sites, it was not possible to classify tumour cells clearly as Sertoli or Leydig in type. In the metastatic lesions there were anaplastic Sertoli cells with abundant collagen fibres. Some neoplastic Sertoli cells and a few neoplastic Leydig cells revealed cytoplasmic reactivity for testosterone. Ultrastructurally, the neoplastic cells were characterized by mitochondria with tubulovesicular cristae, smooth endoplasmic reticulum, membranous structures, lysosomes, lipofuscin granules or lipid droplets.

Malignant sertoli cell tumour of the testis in a child

Very few cases of malignant Sertoli cell tumour of the testis are reported in the literature. The average age at discovery of this tumour is 39 years. Malignant Sertoli cell tumour of the testis in a child is presented, the fourth case reported in the literature. We present our case to increase awareness of this tumour in this age group, to point out the capability of Sertoli cell tumours to metastasize, and to document the remarkable initial response to combination chemotherapy, a hitherto unreported feature.

Sertoli-cell-only syndrome: a case report

A 20-year-old male presented with a small hydrocoele in the left scrotal sac, bilateral small testes, and azoospermia with normal secondary sexual characteristics. Chromosome study revealed 46,XY. The results of hormonal and histopathological studies were consistent with Sertoli-cell-only syndrome.

Ovarian endometrioid carcinomas resembling sex cord-stromal tumors. An immunohistochemical study

Ovarian endometrioid carcinomas resembling sex cord-stromal tumors (ECSCSs) may simulate Sertoli cell tumors, Sertoli-Leydig cell tumors (SLCTs), and adult granulosa cell tumors (AGCTs), both clinically and pathologically. Differing clinical features and histologic findings are almost always successful in distinguishing these tumor types, although in some cases the differential diagnosis is difficult. Immunohistochemical staining of 17 ECSCSs, 14 Sertoli cell tumors or SLCTs, and 15 AGCTs was performed with the use of antibodies against cytokeratins (AE1/AE3, 902, and CAM 5.2), epithelial tumor-associated antigens (EMA, OM-1, B72.3, and carcinoembryonic antigen B1.1), vimentin, S-100, neuron-specific enolase, and lysozyme to determine the immunohistochemical profile of each tumor type and to define further the nature of the sex cord-like components in ECSCSs. All 17 ECSCSs, none of the 15 AGCTs, and one of 14 Sertoli cell tumors or SLCTs stained with EMA. Staining for OM-1 was almost as helpful diagnostically, with positive results for 15 of 17 ECSCSs, 0/15 AGCTs, and 1/14 Sertoli cell or SLCTs. Antikeratins were immunoreactive with all the ECSCSs as well as some of the AGCTs and Sertoli cell tumors or SLCTs. The B72.3 and B1.1 were immunoreactive with some ECSCSs and Sertoli cell tumors, but were nonreactive with AGCTs. Neuron-specific enolase was demonstrated in 11 of 17 ECSCSs, two of 14 Sertoli cell tumors or SLCTs, and 0 of 15 AGCTs. Vimentin, S-100, and lysozyme were least helpful in the differential diagnosis. These studies suggest that an immunohistochemical approach may be useful in the differentiation of ECSCSs and sex cord-stromal tumors. Furthermore, it supports the conclusion that the sex cord-like cells in ECSCSs are not Sertoli or granulosa cells, but cells of surface epithelial type growing in architectural patterns similar to those of sex cord-stromal tumors.

Sertoli-Leydig cell tumor associated with a mature cystic teratoma in a single ovary

Sertoli-Leydig cell tumors of the ovary are rare neoplasms of young women and are best known for their frequent virilizing effects. They have very rarely been reported in association with other ovarian neoplasms. We report such a tumor associated with a mature cystic teratoma in the same ovary. The wide variety of histologic patterns seen in many Sertoli-Leydig cell tumors including the present case, often causing difficulty in diagnosis, is reviewed.

An unusual hormone pattern in a virilized woman affected by Sertoli-Leydig cell tumor. Report of a case

A 24-year-old woman was admitted to hospital because of hirsutism, virilism and amenorrhea, which had appeared 6 months earlier. Endocrinological evaluation showed a slightly elevated serum level of testosterone (1.2 +/- 0.05 ng/ml), normal plasma levels of dehydroepiandrosteronesulfate (DHEA-S) (2,070 +/- 6 ng/ml), androstenedione (1.8 +/- 0.5 ng/ml) and sex hormone-binding globulin (SHBG)(42 +/- 3 nM/L); there was normal urinary 17-ketosteroid (17-KS) excretion (11.7 mg/24 h), low urinary estrogen (E) excretion (3 +/- 0.4 micrograms/24 h), suppressed basal gonadotropin concentrations (LH 0.9 microUI/ml; FSH 3.2 microUI/ml) and an exaggerated response to the LH-RH test. At laparotomy, a monolateral ovarian tumor was found, which was proved histologically to be a Sertoli-Leydig cell tumor. After tumor ablation, a regular menstrual cycle followed and progressive reduction of virilism was noted. This was followed within 4 months by complete normalization of LH, FSH, estrogen and progesterone serum levels. The responsiveness to LH-RH also became normalized. Two years after this operation, the patient had a normal pregnancy. This case of virilization in a woman affected by a benign Sertoli-Leydig cell tumor was primarily characterized by an unusual response of the hypothalamopituitary axis against an endocrinological background of notable alteration of the androgen/estrogen ratio, where the androgens were slightly increased and the estrogens greatly reduced.

Ovarian small cell carcinoma. Histogenetic considerations based on immunohistochemical and other findings

Small cell carcinoma of the ovary is a rare, poorly understood aggressive tumor of young women, associated with paraendocrine hypercalcemia in two-thirds of the cases. Immunohistochemical staining of 15 small cell carcinomas, one-third of which were associated with hypercalcemia, 15 adult granulosa cell tumors, 15 juvenile granulosa cell tumors, and 5 Sertoli cell tumors, was performed with the use of antibodies against cytokeratins (AE-1/AE-3, CAM 5.2, 902), epithelial tumor-associated antigens (B72.3, epithelial membrane antigen [EMA]), vimentin, S-100, neuron-specific enolase (NSE), lysozyme, parathyroid hormone, and chromogranin-A in an attempt to define histogenetically this tumor type. One-third of the small cell carcinomas were positive for EMA, whereas all of them were negative for B72.3 and S-100. In contrast, one-third of the granulosa cell tumors were positive for S-100 and all of them were negative for EMA and B72.3. One of five Sertoli cell tumors were positive for EMA and two were positive for B72.3, but all were negative for S-100. Differences existed in the frequency, intensity, and/or pattern of staining for cytokeratin, vimentin, lysozyme, and NSE among the various tumor types. A single small cell carcinoma from a patient with hypercalcemia stained focally for parathyroid hormone, whereas all 30 granulosa cell tumors and 4 of 5 Sertoli cell tumors were nonreactive. Chromogranin-A staining was noted in four of five small cell carcinomas, none of ten granulosa cell tumors, and two of five Sertoli cell tumors. These immunohistochemical findings, as well as previous light and electron microscopic data, do not clearly indicate any specific cell as the cell of origin of the ovarian small cell carcinoma.

Large-cell calcifying Sertoli cell tumor

We report on a 20-year-old man with a left testicular mass clinically believed to be a malignant neoplasm but subsequently identified as a large-cell calcifying Sertoli cell tumor. This is a rare form of Sertoli cell tumor with unique clinical and pathological features only recently described in the literature. The neoplasm has a low malignant potential with only 1 patient known to have had metastasis. The tumor occurs primarily during the first 2 decades of life and has been associated with endocrine disorders and cardiac myxoma. The clinician should be mindful of this tumor because of its low malignant potential and the necessity to evaluate individuals for endocrine and cardiac abnormalities.

[An alpha-fetoprotein producing Sertoli-Leydig cell tumor--a case report]

A case of an ovarian, poorly differentiated, Sertoli-Leydig cell tumor in a 55-year-old woman is reported. The patient showed no virilization, but did show elevated serum alpha-fetoprotein (AFP) levels. The tumor, measuring 70 x 45 x 50 mm, consisted mainly of a diffuse proliferation of spindle cells. Among this proliferation, some tubules of Sertoli cells and groups of leydig cells were found. Immunoperoxidase studies, using anti-AFP, localized the AFP in the leydig cells.

Frequency of alpha-fetoprotein production by Sertoli-Leydig cell tumors of the ovary: an immunohistochemical study of eight cases

Eight Sertoli-Leydig cell tumors (SLCT) of the ovary were studied by immunostaining for alpha-fetoprotein (AFP). Immunostaining was positive only in cells resembling Leydig cells in three cases and in both Sertoli and Leydig cells in one instance. In one SLCT with positive immunostaining, serum AFP was available and was elevated. Serum level was not measured in the seven other cases. Despite the small number of cases, this study suggests that AFP expression in ovarian SLCT is not unusual. The serum AFP level may, however, depend on the size of the tumor, the proportion of Leydig cells present, and their ability to produce and to release AFP into the bloodstream.

A sertoliform endometrioid adenocarcinoma of the endometrium

Sertoliform endometrioid adenocarcinomas of the ovary are well recognized but, curiously, a sertoliform pattern has not previously been noted in endometrioid adenocarcinomas of the endometrium. An endometrial tumour is described which showed in some areas the typical appearances of an endometrioid adenocarcinoma and in others a pattern closely resembling that of a Sertoli cell tumour.

Malignant Sertoli cell tumour of the testis. An immunohistochemical study and a review of the literature

The fifteenth case of malignant Sertoli cell tumour is reported and the literature is reviewed. The reported case was unilateral with lung metastases. Immunohistochemical examination showed positive staining reaction within the tumour cells for vimentin and cytokeratin, while AFP, HCG, PLAP, EMA and CEA were not found, which is in accordance with the staining pattern found in normal Sertoli cells.

Morphology of canine ovarian Sertoli-Leydig cell neoplasms. A report of 12 cases

Of 71 dogs with primary ovarian neoplasms, 12 (17%) had Sertoli-Leydig cell tumors. Five dogs had Sertoli-Leydig cell tumors, four had pure Sertoli cell tumors, and three had Sertoli-Leydig cell tumors with a retiform pattern. Variously differentiated Sertoli cells were seen in the Sertoli-Leydig cell tumors, and one of these metastasized to the peritoneum. The pure Sertoli cell tumors were similar to these tumors in male dogs. The retiform pattern in the third group of tumors was characterized by tubuloalveolar structures resembling rete testes. Heterologous elements were seen in seven tumors (58%)--enteric glands in three Sertoli-Leydig cell tumors and one Sertoli-Leydig cell tumor with retiform pattern, and neuroendocrine carcinoma in one pure Sertoli cell tumor and two Sertoli-Leydig cell tumors with retiform pattern. The uterus was examined in seven dogs, and six (87%) had endometrial hyperplasia.

In vitro malignant transformation of in vivo ENU-induced rat ovarian Sertoli cell tumor (adenoma)

An N-ethyl-N-nitrosourea-induced rat ovarian Sertoli cell tumor was grown in tissue culture in Dulbecco's modified Eagle's medium (DMEM) supplemented with 25% horse serum (HS) and a hormone combination of 20 ng/ml each of hydrocortisone, insulin, and prolactin. This tissue culture derived from a nonsteroid hormone-producing tumor. Cytofluorometry and karyotyping of the nonhormone-producing tumor cell line (SCTL-1) revealed a diploid pattern for the early passage (P1), which became hyperdiploid (P10), and then aneuploid (P20). These cells had an epitheloid pattern, grew in a monolayer at early passages. After P10 the cells were transplanted into newborn rats and nude mice and resulted in high incidences of tumors (up to 100%). The cell line (SCTL-1) continued to grow in DMEM, 10% HS, and no hormone supplementation after P10. This study revealed that a benign rat ovarian Sertoli cell tumor after multiple passages in vitro underwent sequential genotypic and phenotypic changes and became highly malignant.

An ovarian Sertoli-Leydig cell tumor with heterologous mucinous gland and NSE-immunoreactive-cell

A rare case of ovarian Sertoli-Leydig cell tumor with heterologous mucinous glands and tiny carcinoid-like foci in a 33-year-old female is reported. In addition to these heterologous elements, peculiar cells, which were oval, eosinophilic and neuron-specific enolase (NSE)-positive, were also observed and had not been described previously. These NSE-immuno-reactive cells were different from argentaffin cells observed in mucinous glands and carcinoid-like foci, and seemed to play a significant role in the appearance of the heterologous mucinous gland. The nature of this peculiar NSE-immunoreactive cell is discussed.

Ovarian Sertoli-Leydig cell tumor (androblastoma) with retiform pattern. A clinicopathologic study

The clinicopathologic findings in nine patients with ovarian Sertoli-Leydig cell tumor with retiform pattern are described. The patients ranged in age from 11 months to 23 years; and seven patients were 12 years of age or younger. The most frequent presenting sign was the finding of an abdominal mass. This was associated with pain in five patients. In three patients the pain was severe due to torsion, causing an acute abdominal emergency. Slight virilization was observed in one patient only. Two patients had elevated serum alphafetoprotein (AFP), which correlated well with disease activity. The remaining patients had normal serum AFP. All the tumors were unilateral. At laparotomy the tumor was intact in six patients and ruptured in three. The tumors ranged from 8 to 22 cm, were round or oval, and cystic or solid and cystic. Eight tumors were in FIGO Stage I, and one was associated with abdominal metastases and was Stage III. Histologically, the retiform component varied from moderate to predominant in eight of the nine cases. In two tumors a heterologous component composed of striated muscle was also present. Three patients developed metastases. Two of the patients died 11 months and 2 years after diagnosis and the third patient was lost to follow-up with evidence of disease 2 years after diagnosis. The remaining six patients were well and disease-free for periods of 8 months to 6 years. The majority of these tumors were misinterpreted as serous papillary cystadenocarcinoma or endodermal sinus tumor, which are more malignant neoplasms requiring different therapy. This further underlines the importance of recognizing this histopathologic entity.

Testicular tumors other than germ cell tumors

A heterogeneous group of neoplasms other than those of germ cell type may involve the testis. These tumors vary greatly in their histologic appearances and biologic behavior, and accurate pathologic interpretation is essential to patient care. This review of these various neoplasms emphasizes pathologic aspects, particularly problems in differential diagnosis that may arise.

Canine ovarian neoplasms: a clinicopathologic study of 71 cases, including histology of 12 granulosa cell tumors

In a retrospective study of 71 primary ovarian tumors in the dog, epithelial tumors (46%) were more common than sex cord stromal (34%) and germ cell tumors (20%). There were more adenocarcinomas (64%) than adenomas. Sex cord stromal tumors were equally divided into Sertoli-Leydig (12/24) and granulosa cell tumors (12/24). There were equal numbers (7/14) of dysgerminomas and teratomas among the germ cell tumors. Most teratomas (6/7) were malignant. Most granulosa cell tumors were solid; two were mostly cystic. Patterns included sheets of round and ovoid to spindle-shaped cells separated by thin, fibrovascular stroma; neoplastic cells formed rosettes or Call-Exner bodies. In some areas, neoplastic cells were in cords or columns and formed cyst-like structures. Four granulosa cell tumors were macrofollicular, having cysts lined with granulosa cells. Median ages of dogs with different ovarian neoplasms were similar; all were more than 10 years old, except the dogs with teratoma (mean age, 4 years). Most neoplasms were unilateral (84%), except the Sertoli-Leydig cell tumors, many of which were bilateral (36%). Size of ovarian neoplasms varied (2 cm3 to 15,000 cm3). Twenty-nine percent of neoplasms metastasized; adenocarcinomas (48%) and malignant teratomas (50%) had the highest rates, and distant metastasis was more common in malignant teratoma. Endometrial hyperplasia was in 67% of the dogs; it was most common in dogs with sex cord stromal tumors (95%). Uterine malignancy was not seen in dogs with granulosa cell tumors, although hyperplasia endometrium was in all dogs with this tumor. Cysts in the contralateral ovaries were most common in dogs with sex cord stromal tumors.

Fine needle aspiration cytology of a large cell calcifying Sertoli cell tumor of the testis

A case of a large cell calcifying Sertoli cell tumor (LCCSCT) of the testis in a 7-year-old boy is presented. Fine needle aspiration (FNA) cytologic smears showed large polygonal tumor cells with abundant finely granular or vacuolated eosinophilic cytoplasm and eccentric nuclei with one distinct nucleolus. A variable amount of amorphous calcification was a constant feature. The light microscopic and ultrastructural features of the tumor cells supported a Sertoli cell origin of the tumor. This tumor is found frequently associated with complex endocrine disorders and usually has a benign course. This case, which appears to be the first such case diagnosed by FNA cytology, shows the efficacy of FNA cytology in the presurgical evaluation of testicular masses.

Ovarian neoplasia in the Sprague-Dawley rat

Macroscopic and microscopic characteristics of 210 spontaneous ovarian tumors from 7748 Sprague-Dawley rats are described. The tumors were classified as tubular adenoma, anaplastic adenocarcinoma, papillary cystadenoma, papillary cystadenocarcinoma, mesothelioma, sertoliform tubular adenoma, Sertoli's cell tumor, granulosa cell tumor, thecal cell tumor, polycystic sex cord/stromal tumor, and lipoid cell tumor. The histogenesis of the tumor types is discussed.

[A case of malignant Sertoli cell tumor of the testis]

A 74-year-old man consulted our hospital about a painless swelling of the right scrotal contents. Laboratory findings showed no abnormalities. A right high orchiectomy was performed. The tumor measured 4.2 X 6.0 cm in size and was yellow-white in color. Histologically, the tumor was diagnosed as a malignant Sertoli cell tumor on the basis of findings of invasion and a high mitosis rate. Combined chemotherapy was performed after the operation and no recurrence was found. The Sertoli cell tumor of the testis is a rare neoplasm, and its malignant type is extremely rare. In Japan, 7 cases have been reported, and only 2 of them have been malignant. This case is the 3rd instance malignant Sertoli cell tumor in this country.