Sertoli cell tumor (gonadal stromal tumor) in an infant

Sertoli cell tumor of the testis in children: reevaluation of a rarely encountered tumor

Testis tumors are uncommon in childhood, and they differ from adult tumors in terms of histology and frequency. Sertoli cell tumors appear in children before 1 year of age. They are more frequently benign, but because of the absence of specific signs of malignancy, treatment consists of radical orchiectomy, sometimes followed by radiotherapy or chemotherapy based on histologic analysis. Malignancy is confirmed by the presence of metastasis or many mitosis and anaplastic cells. Children must be followed for several years to be sure of the absence of relapse or progression. In the authors' hospital, of 13 testis tumors diagnosed since 1996, only 2 were Sertoli cell tumors. It would be helpful to have an algorithm for the management of testis tumors, outlining how to make the diagnosis of malignancy and which treatment and follow-up to pursue.

Gonadal stromal tumors: a report of the Prepubertal Testicular Tumor Registry

A total of 15 gonadal stromal tumors in prepubertal boys has been reported to the Prepubertal Testicular Tumor Registry of the Section on Urology of the American Academy of Pediatrics. Leydig cell tumors invariably are benign and patients usually present with precocious puberty when they are 5 to 9 years old. Other gonadal stromal tumors either present in infancy as a scrotal mass and exhibit a benign behavior or occur later in childhood and may be malignant.

Testicular tumors in infants and children

Primary malignant tumors of the testis are uncommon in infants and children. Tumors of germ cell origin are identified most frequently. The clinical presentation is usually due to the presence of an enlarging scrotal mass. Determinations of the serum alpha fetoprotein (AFP) and beta subunit of human chorionic gonadotropin (beta-hCG) levels are helpful for diagnosis and management. All suspected testicular tumors should be surgically evaluated through a high inguinal incision. Postoperative chemotherapy is recommended for some patients with yolk sac tumor and all patients with embryonal rhabdomyosarcoma. Prolonged relapse-free survival is possible for most infants and children with malignant testicular tumors.

Juvenile granulosa cell tumor of the infant testis: case report with ultrastructural observations

This report describes the light-microscopic and ultrastructural features of a juvenile granulosa cell tumor of infant testis. Microscopic examination revealed a macrofollicular patterns simulating the preovulatory Graafian follicle and the juvenile granulosa cell tumor of the ovary. Ultrastructure confirmed three cell types: granulosa, theca interna, and externa, with occasional luteinized cells lacking crystalloids of Reinke. Charcot-Bottcher crystalloids were not detected, though rare cells contained a complex arrangement of filaments. An ultrastructural comparison was carried out with infant testes (2 cases), preovulatory Graafian follicle (1 case), juvenile granulosa cell tumor of ovary, adult granulosa cell tumor of ovary, and adult Sertoli cell tumor of testis and ovary. Ultrastructural similarities were noted between the present case and primitive Sertoli cells, preovulatory granulosa cells, and juvenile granulosa cell tumor of ovary. This may reflect the common histogenesis of Sertoli/granulosa cells from the common specialized gonadal stroma.