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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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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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Saal C, Jeandel R, Boukamel S, Yver M. [Fibrothecoma of the testis: A case report in an adult]. Ann Pathol 2018; 38:249-252. [PMID: 29803360 DOI: 10.1016/j.annpat.2018.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 04/03/2018] [Indexed: 12/01/2022]
Abstract
Fibrothecal tumors belong to sex cord/stromal tumors (SCSTS). They represent 1 to 4.7 % of the organics tumors of ovary (Chechia et al., 2008) but are extremely rare in the testis, with only a few cases described in the literature. We report a new case of a fibrothecoma in the testis in an adult. The extemporaneous diagnosis was made in the same time of the surgical intervention. The castration has been avoided.
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Affiliation(s)
- Caroline Saal
- Service de pathologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France.
| | - Roland Jeandel
- Service de pathologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France
| | - Samir Boukamel
- Service d'urologie, centre hospitalier de Meaux, 6-8, rue Saint-Fiacre, 77104 Meaux, France
| | - Matthieu Yver
- Service de pathologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France
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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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Pathologic Risk Factors in Pediatric and Adolescent Patients With Clinical Stage I Testicular Stromal Tumors. J Pediatr Hematol Oncol 2015; 37:e441-6. [PMID: 26479987 DOI: 10.1097/mph.0000000000000445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Testicular stromal tumors (TSTs) are rare. In adult men with TSTs, various pathologic risk factors have been identified in patients with clinically localized disease that increase the risk of occult metastatic disease (OMD). We systematically reviewed existing literature to analyze the impact of these risk factors on OMD in prepubertal (0 to 12 y) and postpubertal (13 to 21 y) patients. METHODS A literature search was conducted using the combination of terms: "testicular stromal tumors," "testicular leydig cell tumors," "testicular sertoli tumors," "testicular interstitial tumors," "testicular granulosa tumor," and "testicular sex cord tumors." Studies of patients 0 to 21 years with clinical stage I TSTs were included. RESULTS A total of 100 patients from 31 publications were included with a median age at diagnosis of 5.7 years (range, 1.2 mo to 21 y). Seventy-nine patients were 12 years and below (median 7.2 mo) and 21 patients were 13 to 21 years (median 16 y). No patients in either group were identified to have OMD at retroperitoneal lymph node dissection or during follow-up surveillance (median follow-up 45.6 y; range, 4 to 360 mo). 99% of those 12 years and below versus 95% of those above 12 years had 0 to 1 pathologic risk factors, and 1% versus 5% had 2+ pathologic risk factors (P=0.38). CONCLUSIONS Clinical stage I TSTs in adolescent, postpubertal patients appear to behave in a benign manner with few pathologic risk factors, similar to prepubertal patients. Given the low risk of relapse in this population, low-impact surveillance strategies are paramount. Prospective study of these patients is needed, and entry into a tumor registry such as the International Ovarian and Testicular Stromal Tumor Registry is important to learning more about this rare disease.
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Tanner SB, Morilla DB, Schaber JD. A case of adult granulosa cell tumor of the testis. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:471-5. [PMID: 25356877 PMCID: PMC4224105 DOI: 10.12659/ajcr.891389] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patient: Female, 22 Final Diagnosis: Testis granulosa cell tumor Symptoms: Pain in testicles • swelling of epididymides • tenderness of epididymiides Medication: — Clinical Procedure: — Specialty: Urology
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Affiliation(s)
- Stephen B Tanner
- Department of Medical Education, Texas Tech University Paul Foster School of Medicine, El Paso, USA
| | - Dan B Morilla
- Department of Urology, William Beaumont Army Medical Center, El Paso, USA
| | - John D Schaber
- Department of Pathology, William Beaumont Army Medical Center, El Paso, USA
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Cosentino M, Algaba F, Saldaña L, Bujons A, Caffaratti J, Garat JM, Villavicencio H. Juvenile granulosa cell tumor of the testis: a bilateral and synchronous case. Should testis-sparing surgery be mandatory? Urology 2014; 84:694-6. [PMID: 25053523 DOI: 10.1016/j.urology.2014.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/29/2014] [Accepted: 05/05/2014] [Indexed: 10/25/2022]
Abstract
Granulosa cell tumor of the testis is an infrequent stromal cell tumor that can be distinguished into adult and juvenile, the latter being more common. Juvenile granulosa cell tumor of the testis is a rare pathologic finding, accounting for 1.2%-3.9% of prepubertal testicular tumors. It is considered as a benign stromal sex cord tumor and is usually unilateral. Although radical surgery was previously considered the treatment of choice, testis-sparing surgery is now recommended in all cases where applicable. We report a bilateral synchronous juvenile granulosa cell tumor in a 6-month-old child treated with testis-sparing surgery and provide a review of the literature.
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Affiliation(s)
| | - Ferran Algaba
- Pathology Department, Fundació Puigvert, Barcelona, Spain
| | - Lily Saldaña
- Servicio de Cirugía General, Instituto Nacional de Salud del Niño, Lima, Perú
| | - Ana Bujons
- Urology Department, Fundació Puigvert, Barcelona, Spain
| | | | - Jose M Garat
- Urology Department, Fundació Puigvert, Barcelona, Spain
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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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12
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Adult type granulosa cell tumor: a very rare case of sex-cord tumor of the testis with review of the literature. Case Rep Pathol 2013; 2013:932086. [PMID: 23762714 PMCID: PMC3670554 DOI: 10.1155/2013/932086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 04/28/2013] [Indexed: 11/17/2022] Open
Abstract
Granulosa cell tumor (GST) is a sex-cord/stromal neoplasm of the gonads, more commonly arising in the ovaries, while approximately 80 cases have been reported in the testes. Out of these, 30 cases were of the adult type, while the remainder 50 cases were of the juvenile type. The latter mostly concerned infants and followed a benign course. However, the adult type testicular GCTs may be potentially malignant as it also happens in female patients with such neoplasms. We present a case of an adult type GCT located at the left testis. The patient was subjected to total orchiectomy and received no further treatment. Histology showed typical GCT histomorphology with Call-Exner bodies in some places. The immunoprofile of the tumor was CD99 (+), calretinin (+), inhibin (+), alpha smooth muscle actin (+), vimentin (+), ER (-), PR (-), keratin AE1/AE3 (-), alpha fetoprotein (-), CD117 (-), and placental alkaline phosphatase (-). Two years after surgery, the patient is alive and well with no signs of recurrence.
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Lima JF, Jin L, de Araujo ARC, Erikson-Johnson MR, Oliveira AM, Sebo TJ, Keeney GL, Medeiros F. FOXL2 mutations in granulosa cell tumors occurring in males. Arch Pathol Lab Med 2012; 136:825-8. [PMID: 22742556 DOI: 10.5858/arpa.2011-0355-oa] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Granulosa cell tumors comprise less than 5% of ovarian tumors in women and are much rarer in men, with only about 20 cases reported, to our knowledge. Recently, a somatic mutation of FOXL2 was reported in virtually all adult-type granulosa cell tumors in women. OBJECTIVE To investigate FOXL2 mutations in granulosa cell tumors occurring in males. DESIGN Five cases of an adult-type granulosa cell tumor from males were selected from the files of the Mayo Clinic. Nine other testicular tumors (1 juvenile granulosa cell tumor, 5 Leydig cell tumors, and 3 Sertoli-Leydig cell tumors) were evaluated for comparison. Inhibin immunostain was performed in all cases. DNA was extracted from formalin-fixed, paraffin-embedded tissue, followed by polymerase chain reaction and direct sequencing of FOXL2. RESULTS All 5 cases had classic histopathologic features of the adult-type granulosa cell tumor. Inhibin was diffusely positive in all cases. FOXL2 402C→G (C134W) was identified in 40% (2 of 5) of the male, adult-type granulosa cell tumors. Of the 2 tumors positive for the mutation, 1 occurred in the testis of a man, and the other one affected the abdominal ovaries of a phenotypically male patient. All other testicular tumors were negative for the mutation. CONCLUSIONS The FOXL2 402C→G (C134W) mutation is also present in adult-type granulosa cell tumors occurring in men, although in a smaller proportion when compared with the rates reported in women. FOXL2 mutational analysis can be a helpful in the diagnosis of granulosa cell tumors of the testis.
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Affiliation(s)
- Joema F Lima
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
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Bing Z, Bai S. Gynecomastia: An Uncommon but Important Clinical Manifestation for Testicular Tumors. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojpathology.2012.21002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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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Yearley JH, King N, Liu X, Curran EH, O'Neil SP. Biphasic malignant testicular sex cord-stromal tumor in a cotton-top tamarin (Saguinus oedipus) with review of the literature. Vet Pathol 2008; 45:922-7. [PMID: 18984797 DOI: 10.1354/vp.45-6-922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 20-year old male cotton-top tamarin (Saguinus oedipus) was presented with unilateral enlargement of an intrascrotal testicle. Fine-needle aspiration cytology demonstrated a neoplastic population with Call-Exner-like bodies and features of malignancy. The animal was castrated, and histologic examination revealed a biphasic sex cord-stromal tumor, with one region resembling Sertoli-cell tumor and one region resembling granulosa-cell tumor, with extensive microfollicular pattern and many Call-Exner bodies. Eight months after castration, the animal was euthanized on discovery of a caudal abdominal mass that displaced organs, was highly infiltrative, and extended into the paravertebral musculature with lysis of vertebral bone. Metastases to lymph node and lung were also present. Histologic examination of the abdominal tumor showed multifocal formation of Call-Exner bodies in an otherwise highly dedifferentiated population. Positive immunolabeling for alpha inhibin confirmed the sex cord-stromal origin of the abdominal and paravertebral tumor masses. This case has similarities to malignant testicular granulosa-cell tumor of humans.
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Affiliation(s)
- J H Yearley
- New England Primate Research Center, Harvard Medical School, Southborough, MA 01772, USA.
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Kim DJ, Song DW, Yi SY, Yun WY, Jeong TY. Adult Type Granulosa Cell Tumor of the Testis. Korean J Urol 2008. [DOI: 10.4111/kju.2008.49.1.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Dong Jun Kim
- Department of Urology, College of Medicine, Kwandong University, Goyang, Korea
| | - Dong Woo Song
- Department of Urology, College of Medicine, Kwandong University, Goyang, Korea
| | - Sang Yeop Yi
- Department of Pathology, College of Medicine, Kwandong University, Goyang, Korea
| | - Woon Yong Yun
- Department of Urology, College of Medicine, Kwandong University, Goyang, Korea
| | - Tae Yung Jeong
- Department of Urology, College of Medicine, Kwandong University, Goyang, Korea
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