1
|
Giriyan SS, Bharati MB, Shigli NA. Seminoma with focal gonadoblastoma in anatomically normal male: A rare case report. INDIAN J PATHOL MICR 2021; 63:472-474. [PMID: 32769344 DOI: 10.4103/ijpm.ijpm_626_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gonadoblastomas are unusual gonadal neoplasias that frequently appear in dysgenetic gonads. Approximately 80% of patients are phenotypic females and 20% are males. A very high frequency is associated with malignant germ cell tumor. We present a case of 37-year-old normal fertile man with descended testis who presented with swelling and pain in left testis since 6 months. On examination, left testis was swollen, hard, and tender. Ultrasound examination of left testis showed hypoechoic lesion neoplastic with multiple enlarged lymph nodes in pre- and para-aortic region. After high left inguinal orchidectomy, histopathology of specimen showed tumor tissue composed of cells arranged in large nests separated by fibrous stroma infiltrated by lymphocytes with focal area showing nests of cells with vesicular nucleus and moderate amount of eosinophilic cytoplasm with eosinophilic material which was calcified, suggestive of seminoma testis with focal area of gonadoblastoma.
Collapse
Affiliation(s)
- Sujata S Giriyan
- Department of Pathology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - M B Bharati
- Department of Pathology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - Nahida Afshan Shigli
- Department of Pathology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| |
Collapse
|
2
|
Colafranceschi M, Massi D. Gonadoblastoma with Coexistent Features of Mixed Germ Cell-Sex Cord Stroma Tumor: A Case Report. TUMORI JOURNAL 2018; 81:215-8. [PMID: 7571033 DOI: 10.1177/030089169508100314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Gonadoblastoma and mixed germ cell-sex cord stroma tumor have been widely recognized as two separate entities on the basis of both clinical and pathological features. The typical morphological pattern of both tumor types was found by us to coexist in the same gonadal tumor in a 14-year-old 46,XY phenotypically female subject who also had a contralateral dysgerminoma. A subserous implant showing the mixed germ cell-sex cord pattern of the primary tumor was detected in the uterine body. Following therapy the patient is alive and well after a 7-year follow-up. The distinction between gonadoblastoma and mixed germ cell-sex cord stroma tumor requires discussion.
Collapse
Affiliation(s)
- M Colafranceschi
- Istituto di Anatomia e Istologia Patologica, Università degli Studi di Firenze, Italy
| | | |
Collapse
|
3
|
Kao CS, Ulbright TM, Idrees MT. Gonadoblastoma: an immunohistochemical study and comparison to Sertoli cell nodule with intratubular germ cell neoplasia, with pathogenetic implications. Histopathology 2014; 65:861-7. [PMID: 24766183 DOI: 10.1111/his.12444] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/22/2014] [Indexed: 01/01/2023]
Abstract
AIMS To investigate the immunohistochemical properties of the sex cord cells of gonadoblastoma and Sertoli cell nodule with intratubular germ cell neoplasia unclassified (IGCNU) as a means of objective distinction and to provide insight into the pathogenesis. METHODS AND RESULTS Immunohistochemical stains for SOX9, FoxL2 and SF-1 were performed on 10 gonadoblastomas (all phenotypical females) and 14 Sertoli cell nodules with IGCNU in normal phenotypical males with coexisting germ cell tumours. The sex cord cells of gonadoblastomas showed strong, diffuse FoxL2 and SF-1 positivity and focal weak to moderate SOX9 reactivity, whereas those of Sertoli cell nodules with IGCNU were uniformly, strongly positive for SOX9 and SF-1, while negative for FoxL2. CONCLUSIONS Coexpression of SOX9 and FoxL2 in the sex cord cells of gonadoblastomas provides evidence that these morphologically ambiguous sex cord cells are incompletely differentiated. The strong, diffuse SOX9 and SF-1 positivity and absence of FoxL2 reactivity in the Sertoli cell nodules with IGNCU support full Sertoli cell differentiation of the sex cord cells and distinguish them from gonadoblastomas. Deficient SOX9 expression in gonadoblastoma supports a current model of pathogenesis where immature germ cells, in the absence of well-formed Sertoli cells, retain a fetal phenotype and susceptibility to malignant transformation.
Collapse
Affiliation(s)
- Chia-Sui Kao
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | |
Collapse
|
4
|
Grover V, Burman SD, Devi KR, Gupta S, Dhall K. Gonadoblastoma-Dysgerminoma in Streak Ovaries in a 46 XY Individual. ASIA-OCEANIA JOURNAL OF OBSTETRICS AND GYNAECOLOGY 2010; 10:167-71. [PMID: 6541033 DOI: 10.1111/j.1447-0756.1984.tb00670.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
5
|
Jorgensen EV, Steffensen T, Gilbert-Barness E, Nora F, Witt LC. Clinical pathologic correlation: primary amenorrhoea and bilateral adnexal tumors. Fetal Pediatr Pathol 2008; 27:245-58. [PMID: 19065322 DOI: 10.1080/15513810802447920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A case of bilateral gonadoblastoma in 46,XY gonadal dysgenesis is presented and discussed by both clinician and pathologist, in this traditional clinico-pathologic conference. The discussion includes the differential diagnoses of primary amenorrhoea.
Collapse
Affiliation(s)
- E Verena Jorgensen
- Department of Pediatrics, University of South Florida College of Medicine, Tampa, Florida, USA
| | | | | | | | | |
Collapse
|
6
|
Michal M, Vanecek T, Sima R, Mukensnabl P, Hes O, Kazakov DV, Matoska J, Zuntova A, Dvorak V, Talerman A. Mixed germ cell sex cord–stromal tumors of the testis and ovary. Morphological, immunohistochemical, and molecular genetic study of seven cases. Virchows Arch 2006; 448:612-22. [PMID: 16538443 DOI: 10.1007/s00428-006-0155-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Accepted: 01/02/2006] [Indexed: 10/24/2022]
Abstract
We present the morphological, immunohistochemical, and molecular genetic features of three cases of testicular and four cases of ovarian mixed germ cell sex cord-stromal tumors (MGSCT). The germ cells in the testicular MGSCTs morphologically differed from those in classical seminomas by lacking the typical "square off" quality of the nuclei. In contrast to the nuclei in classical seminomas, their size in testicular MGSCTs was smaller and nucleoli were inconspicuous and the cytoplasm was Periodic Acid-Schiff (PAS) negative. Quite on the contrary, the variability in the size of the nuclei of the germ cells in the testicular MGSCTs was more similar to that seen in the germ cells of spermatocytic seminomas. Immunohistochemically, the germ cells of MGSCTs in one case reacted positively with antibody to AE1-AE3 by paranuclear dot-like or rodlike positivity. All three testicular MGSCTs had a negative reaction with the rest of antibodies, including placental alkaline phosphatase (PLAP), OCT4, and c-kit protein. Ovarian MGSCT in our series differed from the testicular lesions in both the germ cell component and the sex cord component. The germ cells in all four ovarian cases had cytomorphological and immunohistochemical features identical to those in classical seminomas/dysgerminomas. They possessed the typical "square off" quality of the nuclei, which were much more blastic, with more mitoses compared with the testicular tumors in our series, and they were PLAP (4/4), OCT4 (4/4) and c-kit protein (3/4) positive immunohistochemically. The cytoplasm of the germ cells in ovarian neoplasms contained PAS positive glycogen. Germ cells in one ovarian MGSCTs showed amplification of 12p. All other germ cells were negative for amplification of 12p. All five successfully analyzed cases showed no mutation in all studied exons and exon-intron junctions in c-kit and PDFGRA genes.
Collapse
Affiliation(s)
- Michal Michal
- Sikl's Department of Pathology, Charles University Hospital, Pilsen, Czech Republic.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Affiliation(s)
- Carl Lam
- King Edward Memorial Hospital, Centre for Women's Health, Perth, Western Australia, Australia
| | | |
Collapse
|
8
|
Costa T, Lambert M, Teshima I, Ray PN, Richer CL, Dallaire L. Monozygotic twins with 45,X/46,XY mosaicism discordant for phenotypic sex. ACTA ACUST UNITED AC 1998. [DOI: 10.1002/(sici)1096-8628(19980106)75:1<40::aid-ajmg9>3.0.co;2-u] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
9
|
Affiliation(s)
- J L Rutgers
- Department of Pathology, Harbor-UCLA Medical Center, Torrance 90509
| |
Collapse
|
10
|
Chapman WH, Plymyer MR, Dresner ML. Gonadoblastoma in an anatomically normal man: a case report and literature review. J Urol 1990; 144:1472-4. [PMID: 2231948 DOI: 10.1016/s0022-5347(17)39772-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Gonadoblastoma, a rare gonadal neoplasm, presents most frequently in phenotypic female or phenotypically male patients with dysgenetic gonads or undescended testes. To date, only 2 cases of gonadoblastoma have been reported in anatomically normal male patients with scrotal testes. Both of these patients presented with testicular masses and germ cell tumors. We report a case of a genotypically and phenotypically normal, fertile man with descended testes who on evaluation for chronic orchialgia had a gonadoblastoma unaccompanied by a germ cell neoplasm. The tumor was nonpalpable and was initially discovered on scrotal ultrasound.
Collapse
Affiliation(s)
- W H Chapman
- General Surgery, Anatomic Pathology and Urology Services, Tripler Army Medical Center, Hawaii
| | | | | |
Collapse
|
11
|
Affiliation(s)
- M O Savage
- Department of Child Health, St Bartholomew's Hospital, London, UK
| | | |
Collapse
|
12
|
Abstract
The case of a 41-year-old man with testicular mixed germ cell-sex cord stroma tumor is reported. The patient noticed a gradual, painless, right-sided testicular enlargement 4 years before being treated by radical orchiectomy. The testis contained a centrally located tumor. There was no evidence of metastases. An histologic examination and an ultrastructural study showed that the tumor was composed of germ cells and sex cord derivatives; the typical features of mixed germ cell-sex cord stroma tumor were present. The patient is well and disease-free 2 years after the operation. Currently, none of the testicular tumors of this type has been associated with metastases or was overgrown by malignant germ cell tumors, and radical orchiectomy resulted in complete cure. The literature regarding this entity is reviewed, the differential diagnosis is discussed, and the importance of making the correct diagnosis is emphasized.
Collapse
Affiliation(s)
- J Matoŝka
- Department of Pathology, Slovak Academy of Sciences, Bratislava, Czechoslovakia
| | | |
Collapse
|
13
|
Abstract
Two cases of hormonally active, metastasizing malignant mixed germ cell-sex cord-stromal tumors are described in otherwise normal prepubertal girls. Isosexual precocity was noted 5 months and 1 month before surgery. One child died 1 year after presentation, and the other was alive, with no apparent tumor, 1 year after diagnosis. These two cases represent the first recorded instance of a unique tumor in which metastases of several cell types were encountered.
Collapse
Affiliation(s)
- A G Lacson
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | |
Collapse
|
14
|
Müller J. Abnormal infantile germ cells and development of carcinoma-in-situ in maldeveloped testes: a stereological and densitometric study. INTERNATIONAL JOURNAL OF ANDROLOGY 1987; 10:543-67. [PMID: 2886440 DOI: 10.1111/j.1365-2605.1987.tb00354.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
15
|
Safneck JR, deSa DJ. Structures mimicking sex cord-stromal tumours and gonadoblastomas in the ovaries of normal infants and children. Histopathology 1986; 10:909-20. [PMID: 3781489 DOI: 10.1111/j.1365-2559.1986.tb02589.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A chance finding of structures resembling gonadoblastomas in the ovaries of a child with lissencephaly prompted a detailed review of all ovarian histology obtained at autopsy over a 12 month period. Fifty-five stillbirths, infants and children were studied ranging from 20 weeks gestational age to 2.5 years post-natal age. In 19 infants structures mimicking gonadoblastomas and sex cord tumours with annular tubules were seen. In all but one case these structures were found in association with follicular cysts and they closely resembled the atretic follicles often seen in the stroma surrounding the follicular cysts. They differed from the atretic follicles only by virtue of their being larger. In addition, in several infants structures resembling Sertoli cell tubules or clusters of Leydig cells were found. When present, these structures always co-existed with sex cord tumours with annular tubules and gonadoblastoma-like lesions. The abnormal stromal lesions and follicular cysts were found most frequently at the stage of development when a massive 'physiological' reduction of oocytes occurs. It is suggested that the 'abnormal' structures identified in this report represent the 'first hit' of oncogenesis and could serve as the precursor of many of the sex cord-stromal tumours, and possibly germ cell neoplasms, seen in childhood.
Collapse
|
16
|
Sekiya S, Iwasawa H, Inaba N, Naito M, Takamizawa H. Mixed ovarian germ cell tumor in 46,X, +mar Turner's syndrome: a case report. ASIA-OCEANIA JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1984; 10:311-316. [PMID: 6525086 DOI: 10.1111/j.1447-0756.1984.tb00692.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
17
|
Abstract
Based on earlier studies relative to development and maturation of human gonads, a hypothesis is presented, namely, that the production of "psammoma bodies" in gonadoblastoma, as well as intensification of calcification and hyalinization processes, may be an expression of recapitulation of the involution phase of the indifferent gonad and the terminal phase of proliferating activity in the sex cords of such lesions. It is also suggested that pathologic structures found in the medulla of the ovaries of fetuses and newborn infants favor the development of gonadoblastomas and that the latter are formed as the result of dysfunction of a genetic system controlling gonadal maturation and thus are not "neoplasms."
Collapse
|
18
|
Pfeiffer RA, Tietze U, Krone HA, Schaaff A, Dhom G, Peter H. Invasive dysgerminoma in a girl with 45,X/46,X; mar mosaicism. ARCHIVES OF GYNECOLOGY 1983; 233:141-7. [PMID: 6882018 DOI: 10.1007/bf02114790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We report a 16-year-old girl with features of Turner's syndrome from whom an invasive dysgerminoma was removed. Cytotoxic drugs were given for the next 12 months. Mosaicism of two karyotypes (45,X/46,X; mar) was found in various tissues. The literature is reviewed with special regard to cytogenetic findings and prognosis of malignant growth and differentiation of dysgenetic gonads.
Collapse
|
19
|
|
20
|
Abstract
The secure deduction of tumor histogenesis in vivo is notoriously difficult, owing to the retrospective form of the inquiry, which implies that no histogenetic theory makes certain-enough predictions. Deduction of a tumor's parent tissue currently relies on 1) its location relative to that of small early tumors, 2) correlation of its relative availability with tumor frequency, 3) its resemblance to the tumor tissue in various respects, and 4) its microscopic continuity with the tumor through transitional forms. Each of these criteria has pitfalls, owing to possible failure of the relevant factor to persist or to subsequent mimicry of it by other processes. This makes reliance on only one or two criteria undesirable. The application of these criteria to teratomas shows that there are no convincing data provided by the fourth. A dysgerminoma containing multiple small teratoid foci, which was studied in detail, is described, and the origin of the second tissue from the first is argued. The apparently somatic origin of some of the mesenchyma and the role of the mesenchyma in promoting teratoma development and segregation are discussed.
Collapse
|
21
|
Fisher RA, Salm R, Spencer RW. Bilateral gonadoblastoma/dysgerminoma in a 46 XY individual: case report with hormonal studies. J Clin Pathol 1982; 35:420-4. [PMID: 7076870 PMCID: PMC497673 DOI: 10.1136/jcp.35.4.420] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A case of bilateral gonadoblastoma/dysgerminoma in a 46 XY phenotypical female is presented. Increased circulating beta human chorionic gonadotropin (beta-HCG) and testosterone together with a decreased concentration of follicle stimulating hormone (FSH) reflected the activities of these tumours. The patient is alive and well three years later, after treatment by surgery and cobalt therapy.
Collapse
|
22
|
Mostofi F. Editorial Comment. J Urol 1982. [DOI: 10.1016/s0022-5347(17)53768-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- F.K. Mostofi
- Armed Forces Institute of Pathology Washington, D. C
| |
Collapse
|
23
|
Abstract
A tumor of the left testicle resembling a gonadoblastoma was an incidental finding at necropsy in a 15-year-old male Shetland Sheepdog. This neoplasm was characterized by discrete intratubular aggregates of intimately mixed germ cells and smaller cells resembling Sertoli cells. The latter small cells often formed a single cell layer surrounding the margin of eosinophilic, PAS-positive Call-Exner-like bodies. Electron microscopy showed these bodies to be composed of whorled laminae resembling basement membrane.
Collapse
|
24
|
|
25
|
Pickartz H, Moltz L, Altenähr E. XY (h-y+) gonadal dysgenesis. Morphological examination of 4 cases by light and electron microscopy. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOLOGY 1980; 389:103-17. [PMID: 7192897 DOI: 10.1007/bf00428671] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The gonads of 4 phenotypically female individuals with XY chromosomal constitution and signs of virilisation were examined by light microscopy. Electron microscopic examination was also performed in two cases. Serological analysis of H-Y antigen titer yielded positive results. The matrix of the gonads is shown to be ovarian stroma, in which tubular and follicular structures are embedded. The epithelia of the follicles resemble granulosa cells of the ovary, the tubular epithelia are resemble Sertoli cells. Tubules and follicles both show extensive regressive changes. A varying number of Leyding cells/stroma lutein cells were found in each gonad. The different degree of development of testicular and ovarian structures in the dysgenetic gonads might be explained by a defect of the gonadal specific receptor for the H-Y antigen, this defect varying in time of occurrence, duration and severity.
Collapse
|
26
|
Damjanov I, Klauber G. Microscopic gonadoblastoma in dysgenetic gonad of an infant: an ultrastructural study. Urology 1980; 15:605-9. [PMID: 7394994 DOI: 10.1016/0090-4295(80)90380-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A microscopic gonadoblastoma found in the dysgenetic gonad of a six-month-old phenotypic female with a 46,XY genotype was studied with the electron microscope and compared with the cells from the testicular portion of the contralateral gonad. The germ cells within the tumor resembled the testicular germ cells and were not different from previously described germ cells in other gonadoblastomas of postpubertal patients. The sex cord cells of the present tumor were inactive and immature, but differed from the Sertoli cells of the patient's testis. The presence of hyalin globules and Call-Exner bodies in the epithelial tumor nests, coupled with the ultrastructural appearance of the sex cord cells is more consistent with them being immature granulosa rather than Sertoli cells. The immaturity of the sex cord cells in gonadoblastoma of this infant suggest that they are responsive to normal regulatory hormonal influences.
Collapse
|
27
|
Abstract
Gonadoblastomas have a propensity to give rise to germ cell neoplasms. This study analyzes the clinicopathologic findings in six phenotypic females with features of 46,XY pure gonadal dysgenesis who developed germinomas and other germ cell tumors in gonadoblastomas. All stages in the evolution of germinoma from the germ cells of gonadoblastoma were observed, including in situ, incipient, microinvasive, and metastatic varieties. Admixtures with teratoma and endodermal sinus tumor occurred in two patients. Germ cell tumors which originate in gonadoblastomas appear to have the same clinical behavior and response to therapy as those that arise de novo in the ovary, testis or extragonadal sites. Although it is debatable whether gonadoblastomas are true neoplasms or blastomatoid dysgenetic malformations, their potential for giving rise to fully malignant germ cell neoplasms must be recognized.
Collapse
|
28
|
Foulkes J, Nicholls PE. A case of dysgerminoma-gonadoblastoma in pure gonadal dysgenesis. Aust N Z J Obstet Gynaecol 1979; 19:52-5. [PMID: 292421 DOI: 10.1111/j.1479-828x.1979.tb01353.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
29
|
Talerman A, van der Harten JJ. Mixed germ cell-sex cord stroma tumor of the ovary associated with isosexual precocious puberty in a normal girl. Cancer 1977; 40:889-94. [PMID: 196747 DOI: 10.1002/1097-0142(197708)40:2<889::aid-cncr2820400244>3.0.co;2-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A case of mixed germ cell-sex cord stroma tumor occurring in a normal 8-year-old girl with 46XX karyotype is reported. The child presented with evidence of isosexual precocious puberty 3 years prior to the excision of the tumor. Although the tumor was known to be present at least 2 years prior to its excision and weighed more than 1 kg, there was no evidence of involvement of the adjacent organs or metastases at the time of excision. The contralateral ovary was normal. The endocrine activity abated following the excision of the tumor and the patient is well and free of disease 2 years after the operation. The literature concerning this entity is discussed and reviewed.
Collapse
|
30
|
Williamson HO, Underwood PB, Kreutner A, Rogers JF, Mathur RS, Pratt-Thomas HR. Gonadoblastoma: clinicopathologic correlation in six patients. Am J Obstet Gynecol 1976; 126:579-85. [PMID: 984129 DOI: 10.1016/0002-9378(76)90755-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Six patients with a total of nine gonadoblastomas are presented; three--and possibly a fourth--had dysgerminomatous overgrowth which was massive in two patients. Calcification detected by abdominal films was present in three sufficient for preoperative diagnosis. All patients were found to have a Y stem line on peripheral leukocyte chromosome cultures except one patient, who had a 46 XX/45 XO karyotype. She was found to have Y chromatin bodies in the germ cells of her tumor which was in a normal ovary found at exploration for an ectopic pregnancy. Three were found in virilized phenotypic females investigated for amenorrhea, and two for therapy of pelvic masses due to dysgerminomatous overgrowth. Y chromatin studies are reported on gonadal tissue.
Collapse
|
31
|
Abstract
An exceedingly rare ovarian neoplasm composed of mixed thyroid and Brenner tumor is reported. Review of the literature yielded only one well-documented case previously described. Although the possibility of a "collision" of two different tumors cannot be completely discarded, a possibility of an endodermal teratoma (thyroid-urothelium) is also proposed.
Collapse
|
32
|
Garvin AJ, Pratt-Thomas HR, Spector M, Spicer SS, Williamson HO. Gonadoblastoma: histologic, ultrastructural, and histochemical observations in five cases. Am J Obstet Gynecol 1976; 125:459-71. [PMID: 988750 DOI: 10.1016/0002-9378(76)90359-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this series of gonadoblastomas it appeared that the germ cells were the motivating force underlying either tumor proliferation or regression. The ultrastructural morphology confirmed the presence of undifferentiated gonadal cells with active steroid synthesis by the interstitial cells. The Call-Exner-like bodies which showed extensive calcification were composed of basement membrane material containing a sulfated mucosubstance. A histochemical comparison with the noncalcifying Call-Exner bodies of a granulosa-cell tumor differed only in their glycoprotein content. The calcium deposits were identified as oriented hydroxyapatite crystals by electron diffraction, and it is proposed that the basement membrane material serves as a nucleation site for calcification. High serum testosterone levels were correlated with the presence solely of interstitial cells in one case. The finding of a gonadoblastoma without the presence of a Y chromosome contradicts earlier proposals concerning the requirement of a Y chromosome for germ cell proliferation.
Collapse
|
33
|
Abstract
The importance of the Y-chromosome for the germ cell tumour development in gonadal dysgenesis has been emphasized many times. In contrast, only two cases of dysgerminoma or gonadoblastoma had been published so far in the XO-Turner's syndrome. With this report, another case of Turner's syndrome developing a dysgerminoma in a gonadal streak is presented. No Y-chromosome containing stemline could be detected in the patient nor in the tumour. A primary genetic etiology or a mechanism related to early secondary regression or dysgenesis of the gonad are discussed as causative factors in germ cell tumour development within gonadal streaks.
Collapse
|
34
|
|
35
|
Abstract
A gonadoblastoma arising in the dysgenetic gonad of a virilized 17-year-old Caucasian with a female phenotype and with a 45,X0/46, X-ring-Y genotype was studied by light microscopic histochemistry, electron microscopy, and ultrastructural histochemistry. The gonadoblastoma was composed of nests of cells containg large germ cells and small "granulosa-Sertoli-like cells," and stromal tissue containing "Leydig-like cells." The germ cells were identical to those found in normal fetal gonads and in germ cell tumors. Charcot-Böttcher crystalloids present in the "granulosa-Sertoli-like cells" strongly suggest that they are, in fact, Sertoli cells. Multilayered basal laminae located in the periphery of the tumor nests and in "hyaline bodies" were identical to those surrounding the seminiferous tubules of the adult testis. The "Leydig-like cells" present in the stroma contained occasional dense bodies and crystalloids which characterize the Leydig cells of the fetal testis. Delta 5-3 beta hydroxysteroid dehydrogenase activity was demonstrated in the periphery of lipid droplets and lysosome-like dense bodies of the Leydig cells, and in some Sertoli cells. The findings support the theory that gonadoblastoma arises in a dysgenetic testis rather than in a dysgenetic ovary.
Collapse
|
36
|
Manuel M, Katayama PK, Jones HW. The age of occurrence of gonadal tumors in intersex patients with a Y chromosome. Am J Obstet Gynecol 1976; 124:293-300. [PMID: 1247071 DOI: 10.1016/0002-9378(76)90160-5] [Citation(s) in RCA: 261] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A total of 320 intersex patients with a Y chromosome were classified into four groups; (1) gonadal dysgenesis, (2) asymmetrical gonadal differentiation, (3) virilizing male hermaphroditism and (4) feminizing male hermaphroditism (testicular feminization syndrome). Of these 320 cases, 98 were from the files of The Johns Hopkins Hospital and the remainder from the literature. The incidence of tumors in relation to age and clinical classification was analyzed by computer. The results were plotted for each group. It was found that the percentage of tumors rose appreciably soon after the age of puberty in the first three groups, and it was concluded that the gonads were best removed before the age of puberty. In the case of testicular feminization patients, procrastination until the age of 25 could be considered, if one were willing to assume the risk of neoplasia of about 3.6 per cent until then.
Collapse
|
37
|
Abstract
A case of gonadoblastoma associated with embryonal carcinoma in a normally decended testis of an anatomically normal 20-year-old man is reported. The patient had enlargment of the supraclavicular lymph nodes, which contained metastatic yolk sac tumor. Pulmonary and abdominal metatases were present. Despite chemotherapy and radiotherapy the patient died 9 months after presentation. Review of the literature concerning gonadoblastoma in phenotypic male patients is presented.
Collapse
|
38
|
Mackay AM, Pettigrew N, Symington T, Neville AM. Tumors of dysgenetic gonads (gonadoblastoma): ultrastructural and steroidogenic aspects. Cancer 1974; 34:1108-25. [PMID: 4278968 DOI: 10.1002/1097-0142(197410)34:4<1108::aid-cncr2820340422>3.0.co;2-l] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
39
|
Serra A, Moneta E, Patrono V, Pizzolato G. A phenotypically Turner-like female with karyotype 45,X/46,XY, gonadoblastoma and fluorescent Y. HUMANGENETIK 1974; 24:309-18. [PMID: 4442874 DOI: 10.1007/bf00297595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
40
|
|
41
|
|
42
|
Kariminejad MH, Movlavi MA, Nasserghodssi MA, Ghafoorzadeh D, Behjatnia Y. Gonadoblastoma associated with mixed gonadal dysgenesis. Am J Obstet Gynecol 1972; 113:410-4. [PMID: 4673966 DOI: 10.1016/0002-9378(72)90693-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
43
|
Drobnjak P, Damjanov I, Grizelj V, Kalafatic Z, Longhino N. Precocious puberty with masculinization due to terato-chorio-gonadoblastoma. THE JOURNAL OF OBSTETRICS AND GYNAECOLOGY OF THE BRITISH COMMONWEALTH 1971; 78:845-52. [PMID: 4328962 DOI: 10.1111/j.1471-0528.1971.tb00351.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|