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Bordiya S, Priyanka K, Garg D. Malignant granulosa cell tumor of testis with metastasis to liver: Case report and review of literature. INDIAN J PATHOL MICR 2021; 63:470-471. [PMID: 32769343 DOI: 10.4103/ijpm.ijpm_436_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a case of testicular granulosa cell tumor of adult type in a 65-year-old male patient who has presented with hepatic metastasis. Although, this type of sex cord stromal tumor is relatively common in the ovaries, it is extremely unusual in the testis, and it probably represents the rarest type of testicular sex cord stromal tumor.
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Affiliation(s)
- Sandhya Bordiya
- Department of Pathology, RNT Medical College, Udaipur, Rajasthan, India
| | - Kumari Priyanka
- Department of Pathology, RNT Medical College, Udaipur, Rajasthan, India
| | - Dharmendra Garg
- Department of Pathology, RNT Medical College, Udaipur, Rajasthan, India
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2
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Adult Granulosa Cell Tumor of the Testis: A Case Report with a Review of the Literature. Case Rep Urol 2019; 2019:7156154. [PMID: 31236304 PMCID: PMC6545753 DOI: 10.1155/2019/7156154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022] Open
Abstract
Adult granulosa cell tumor (AGCT) of the testis represents a very rare testicular neoplasm that is poorly understood clinically. Here we report the case of a 22-year-old male who presented with unspecific scrotal symptoms. Scrotal sonography disclosed a 6 mm hypoechoic intratesticular lesion. Histological examination after orchiectomy revealed a homogeneous and well demarcated neoplasm with monomorphic cells with nuclear grooving and microfollicular formation of the so-called Call-Exner bodies. Immunohistology showed positive stainings of vimentin, calretinin, and inhibin with negative stainings of the typical germ cell tumor markers. Thus, the diagnosis of a benign AGCT was made. The patient is well one year after surgery. A total of 91 previous AGCT cases were identified in the literature. Median age of the cases reported to date is 44 years, median tumor size 3.2 cm. 54.3% of the AGCT cases were located on the left side. 12 cases (13.2%) were of malignant nature. Testis-sparing surgery would be the treatment of choice, but only two of all cases had received that procedure. The present report aims to increase the clinical knowledge of AGCT and specifically to increase the clinician's vigilance with respect to testis-sparing surgery in probably benign testicular masses.
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3
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Rove KO, Maroni PD, Cost CR, Fairclough DL, Giannarini G, Harris AK, Schultz KAP, Cost NG. Pathologic Risk Factors for Metastatic Disease in Postpubertal Patients With Clinical Stage I Testicular Stromal Tumors. Urology 2016; 97:138-144. [DOI: 10.1016/j.urology.2016.06.066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/02/2016] [Accepted: 06/08/2016] [Indexed: 11/26/2022]
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Vallonthaiel AG, Kakkar A, Singh A, Dogra PN, Ray R. Adult granulosa cell tumor of the testis masquerading as hydrocele. Int Braz J Urol 2016; 41:1226-31. [PMID: 26742984 PMCID: PMC4756952 DOI: 10.1590/s1677-5538.ibju.2014.0187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 06/04/2014] [Indexed: 12/25/2022] Open
Abstract
Adult testicular granulosa cell tumor is a rare, potentially malignant sex cord-stromal tumor, of which 30 cases have been described to date. We report the case of a 43-year-old male who complained of a left testicular swelling. Scrotal ultrasound showed a cystic lesion, suggestive of hydrocele. However, due to a clinical suspicion of a solid-cystic neoplasm, a high inguinal orchidectomy was performed, which, on pathological examination, was diagnosed as adult granulosa cell tumor. Adult testicular granulosa cell tumors have aggressive behaviour as compared to their ovarian counterparts. They may rarely be predominantly cystic and present as hydrocele. Lymph node and distant metastases have been reported in few cases. Role of MIB-1 labelling index in prognostication is not well defined. Therefore, their recognition and documentation of their behaviour is important from a diagnostic, prognostic and therapeutic point of view.
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Affiliation(s)
| | - Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Animesh Singh
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Prem N Dogra
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Ruma Ray
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Al-Alao O, Gul T, Al-Ani A, Bozom IA, Al-Jalham K. Adult-type granulosa cell tumour of the testis: Report of a case and review of the literature. Arab J Urol 2016; 14:44-9. [PMID: 26966593 PMCID: PMC4767788 DOI: 10.1016/j.aju.2015.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/20/2015] [Accepted: 12/26/2015] [Indexed: 12/25/2022] Open
Abstract
Granulosa cell tumours (GCTs) can be either juvenile or adult type, and more commonly occur in the ovaries. Adult-type GCTs of the testis (AGCTT) are very rare and only 46 cases have previously been reported. We report here on a 48-year-old Filipino man with a left testicular AGCTT, which measured 1.2 × 1.2 × 1.0 cm. He underwent radical orchidectomy with postoperative surveillance for 1 year, which included computed tomography with oral intravenous contrast and clinical examinations, which have been unremarkable. The previously reported AGCTTs were briefly reviewed.
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Affiliation(s)
- Osama Al-Alao
- Urology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
- Corresponding author at: Urology Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. Tel.: +974 66347678.Urology DepartmentHamad General HospitalHamad Medical CorporationPO Box 3050DohaQatar
| | - Tawiz Gul
- Urology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ammar Al-Ani
- Urology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Issam A. Bozom
- Histopathology Section, Laboratory Medicine and Pathology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Al-Jalham
- Urology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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Sharma P, Dhillon J, Sexton WJ. Intratubular Germ Cell Neoplasia of the Testis, Bilateral Testicular Cancer, and Aberrant Histologies. Urol Clin North Am 2015. [PMID: 26216815 DOI: 10.1016/j.ucl.2015.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intratubular germ cell neoplasia (ITGCN) is a precursor lesion for testicular germ cell tumors, most of which are early stage. ITGCN is also associated with testicular cancer or ITGCN in the contralateral testis, leading to a risk of bilateral testicular malignancy. Testicular biopsy detects most cases, and orchiectomy is the treatment of choice in patients with unilateral ITGCN. Low-dose radiation therapy is recommended in patients with bilateral ITGCN or ITGCN in the solitary testis, but the long-term risks of infertility and hypogonadism need to be discussed with the patient. Rare histologies of primary testicular cancer are also discussed.
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Affiliation(s)
- Pranav Sharma
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Jasreman Dhillon
- Department of Genitourinary Anatomic Pathology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Wade J Sexton
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
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Schubert TEO, Stoehr R, Hartmann A, Schöne S, Löbelenz M, Mikuz G. Adult type granulosa cell tumor of the testis with a heterologous sarcomatous component: case report and review of the literature. Diagn Pathol 2014; 9:107. [PMID: 24894598 PMCID: PMC4100032 DOI: 10.1186/1746-1596-9-107] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 05/01/2014] [Indexed: 12/30/2022] Open
Abstract
Adult testicular granulosa cell tumors are rare sex cord- stromal tumors of which only 45 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. We report here a unique case of a 78-year Caucasian with a left sided adult type granulosa cell tumor with a heterologous sarcomatous tumor component. A heterologous sarcomatous component has occasionally been observed in ovarian tumors but never in testicular granulosa cell tumors. The sarcomatous component showed a higher number of mitotic figures (1/Hpf) and a marked proliferation rate (up to 50% Ki 67 positive cells) compared with the granulosa type tumor component. CD 99 and the progesterone receptor were positive in both tumor components, inhibin and calretinin only in the granulosa cells, and pancytokeratin only in the sarcomatouse one. Key words: testis - ovary - granulosa cells - sarcoma - inhibin Runing title: testicular sarcomatous granulosa tumor.
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Affiliation(s)
| | | | | | | | | | - Gregor Mikuz
- Institute of Pathology, Medical University Innsbruck, Muellerstrasse 44, A-6020 Innsbruck, Austria.
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Menon S, Desai S, Bakshi G, Joshi A, Rane S. Granulosa cell tumor of testis: Clinicopathological correlation of a rare tumor. INDIAN J PATHOL MICR 2014; 57:564-73. [DOI: 10.4103/0377-4929.142665] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kanthan R, Senger JL, Kanthan S. The multifaceted granulosa cell tumours-myths and realities: a review. ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:878635. [PMID: 23008780 PMCID: PMC3449135 DOI: 10.5402/2012/878635] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 07/05/2012] [Indexed: 12/17/2022]
Abstract
Background. Granulosa cell tumors (GCTs), representing ~2% of ovarian tumours, are poorly understood neoplasms with unpredictable and undetermined biological behaviour. Design. 5 unusual presentations of GCT and a retrospective 14-year (1997–2011) surgical pathology review based on patient sex, age, tumour type and concurrent pathology findings are presented to discuss the “myths and realities” of GCTs in the context of relevant evidence-based literature. Results. The 5 index cases included (1) a 5 month-old boy with a left testicular mass, (2) a 7-day-old neonate with a large complex cystic mass in the abdomen, (3) a 76-year-old woman with an umbilical mass, (4) a 64-year-old woman with a complex solid-cystic pelvic mass, and (5) a 45 year-old woman with an acute abdomen. Pathological analysis confirmed the final diagnosis as (1) juvenile GCT, (2) macrofollicular GCT, (3) recurrent GCT 32 years later, (4) collision tumour: colonic adenocarcinoma and GCT, and (5) ruptured GCT. Conclusion. GCT is best considered as an unusual indolent neoplasm of low malignant potential with late recurrences that can arise in the ovaries and testicles in both the young and the old. Multifaceted clinical presentations coupled with the unpredictable biological behaviour with late relapses are diagnostic pitfalls necessitating a high degree of suspicion for accurate clinical and pathological diagnosis.
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Affiliation(s)
- Rani Kanthan
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada S7N-0W8 ; Department of Pathology and Laboratory Medicine, Royal University Hospital, 103 Hospital Drive, Room 2868, G-Wing, Saskatoon, SK, Canada S7N-0W8
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Song Z, Vaughn DJ, Bing Z. Adult type granulosa cell tumor in adult testis: report of a case and review of the literature. Rare Tumors 2011; 3:e37. [PMID: 22355492 PMCID: PMC3282442 DOI: 10.4081/rt.2011.e37] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 08/09/2011] [Indexed: 12/18/2022] Open
Abstract
Granulosa cell tumors can be classified into juvenile and adult types and more commonly occur in ovaries. Adult testicular granulosa cell tumors are extremely rare and only 29 cases of adult type have previously been reported. We report here a 28-year old Caucasian man with a left testicular adult type granulosa cell tumor. The tumor measured 2.6×2.6×2.5 cm and was mitotically active (10/10 HPF). Immunohistochemical stains showed the tumor diffusely positive for inhibin and vimentin, and negative for epithelial membrane antigen, cytokeratins, synaptophysin, HMB-45, OCT-4, placental-like alkaline phosphatase and lymphoid markers. The reported granulosa cell tumors in adult testis were briefly reviewed.
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Affiliation(s)
- Zhao Song
- Department of Surgery, Jinan Central hospital, Jinan, Shandong, P. R. China
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Hanson JA, Ambaye AB. Adult Testicular Granulosa Cell Tumor: A Review of the Literature for Clinicopathologic Predictors of Malignancy. Arch Pathol Lab Med 2011; 135:143-6. [DOI: 10.5858/2009-0512-rsr.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Adult testicular granulosa cell tumors are rare sex cord–stromal tumors of which only 28 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. To date, there are no clinical or pathologic features that definitively predict malignancy. We reviewed all prior case reports for features that may predict their malignant potential. Tumor size greater than 5.0 cm is the only feature statistically associated with malignancy. Mitotic count, tumor necrosis, patient age, and the presence of gynecomastia do not, at present, predict benign versus malignant behavior.
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Hammerich KH, Hille S, Ayala GE, Wheeler TM, Engers R, Ackermann R, Mueller-Mattheis V. Malignant advanced granulosa cell tumor of the adult testis: case report and review of the literature. Hum Pathol 2008; 39:701-9. [PMID: 18304605 DOI: 10.1016/j.humpath.2007.09.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 09/19/2007] [Accepted: 09/24/2007] [Indexed: 11/19/2022]
Abstract
Testicular granulosa cell tumors (GCTs) are very rare neoplasms. Although adult GCTs are thought to have a relatively indolent course, several reports have demonstrated the malignant potential of these lesions. In case of distant metastases, the overall survival is very short. To date, there is no well-established treatment for these tumors owing to poor results and very rapid progression. A 55-year-old male patient was diagnosed with a testicular GCT with distant lung metastases. He underwent surgical treatment with orchiectomy and adjuvant polychemotherapy (cisplantine, etoposide, and bleomycine) as well as metastasectomy of the right lung. We report the first case of a successfully treated testicular GCT with bipulmonary metastases at initial diagnosis. Thirty-nine months after treatment, the patient is alive with no evidence of disease. We subsequently reviewed all reported cases of an adult GCT in the published literature (25 published cases). This review will summarize all reported cases and discuss treatment options. The current case suggests that a combination of varying treatment modalities could be a promising and reasonable way to manage malignant advanced GCT of the adult testis.
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Affiliation(s)
- Kai H Hammerich
- Department of Urology, University Hospital of Duesseldorf, 40225 Duesseldorf, Germany.
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Abstract
A 25-year-old man presented with epididymoorchitis. Sonography revealed a 5 mm hypoechoic lesion with scattered foci of high level echoes and an area of calcification in the upper pole of the left testicle close to the hilum. Growth and pronounced neovascularity was demonstrated a subsequent scan. An orchidectomy was performed and histological studies revealed a granulosa cell tumour of the testicle. Testicular granulosa cell tumors are extremely rare. Comparing the previously published findings to our case, we suggest that common sonographic features of testicular granulosa cell tumors include a hypoechoegenic lesion with hyperechoic and calcified foci, sharply defined edge, and internal vascularity.
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