Presentation
A 28-year-old male presented to the urology department of our hospital complaining of a painless mass in the right testicle that had been present for the past 2 years. [ncbi.nlm.nih.gov]
In conclusion, our case of LCCSCT is a rare and distinctive entity and presents a diagnostic challenge for pathologists. We hope that the present report will help in future diagnostic and treatment decisions. References 1. Proppe KH, Scully RE. [jpatholtm.org]
However, up to 20 % of the patients with sex cord-stromal tumors present with distant metastasis at the time of presentation. Like germ cell tumors, sex cord-stromal tumors are usually seen in young adults. [lecturio.com]
May present in both pediatric and adult males, depending on the histologic subtype. Testicular mass or firmness. May occasionally present with precocious pseudopuberty or gynecomastia. [radiopaedia.org]
Entire Body System
- Pain
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. [ncbi.nlm.nih.gov]
On further questioning, the patient remarks that he first noticed it 6 months ago, but did not think he needed to have it examined since it wasn't painful. Transillumination of the scrotum does not reveal translucency. [medbullets.com]
Other symptoms include scrotal heaviness or lower abdominal pain (10%). A minority of the patients present with endocrine disorders, such as gynecomastia, impotence, loss of libido or precocious virilization. [sonoworld.com]
Patients with Leydig cell tumors might develop testicular pain due to hematoma. Patients with Sertoli cell tumors might present with excess estrogen production and gynecomastia as already explained. [lecturio.com]
- Precocious Puberty
The clinical findings, biochemical assay and ultrasound, findings in our case excluded causes of gynecomastia such as congenital adrenal hyperplasia, true precocious puberty or ectopic gonadotropic production. [sjkdt.org]
puberty in boys Physical exam solid mass of the testes is always cancer Prognosis Seminoma late metastasis and excellent prognosis Embryonal worse prognosis than seminoma Choriocarcinoma worst prognosis in contrast to good prognosis in females metastasizes [medbullets.com]
Leydig and Sertoli cells are functionally active and patients with these tumors will have an excess of either testosterone or estrogen, which can result in precocious puberty. [lecturio.com]
The tumors do not cause precocious puberty or abnormally elevated serum AFP levels. Ultrasound findings include a cystic or partly cystic mass with solid components. [appliedradiology.com]
It is recommended to perform annual physical examination and ultrasound in case of detection abnormalities or signs of precocious puberty 1. [ibimapublishing.com]
- Pathologist
Corresponding Author Assistant Pathologist Harvard Medical School, Children's Hospital Medical Center, Boston, Massachusetts Department of Pathology, Children's Hospital Medical Center, 300 Longwood Avenue, Boston, MA 02115=== Search for more papers by [onlinelibrary.wiley.com]
Final diagnosis requires a pathologist to analyze the tumor under a microscope and so surgical removal of the tumor itself (Testicle Sparing Surgery, TSS) or the entire testicle (Orchiectomy) is needed. [otstregistry.org]
In conclusion, our case of LCCSCT is a rare and distinctive entity and presents a diagnostic challenge for pathologists. We hope that the present report will help in future diagnostic and treatment decisions. References 1. Proppe KH, Scully RE. [jpatholtm.org]
The above differences and immunohistochemical ones ( Figure 10 ) (see below) will enable the two neoplasms to be distinguished provided the pathologist is aware of this pitfall. [nature.com]
Inhibin immunohistochemical staining: a practical approach for the surgical pathologist in the diagnoses of ovarian sex cord-stromal tumors. Adv Anat Pathol. 2003;10:27-38. [uscapknowledgehub.org]
- Weakness
SCTs-NOS and the Sertoli cell components in the SLCTs occasionally showed focal and weak/moderate positivity for S-100 alpha, S-100 beta, and wbS-100. Sex cord cells of the GBLs were positive for S-100 beta and wbS-100 and negative for S-100 alpha. [ncbi.nlm.nih.gov]
Respiratoric
- Aspiration
Abstract A rare case of malignant Sertoli cell tumor of the testis occurred in which the diagnosis was initially suggested on fine needle aspiration cytology. [ncbi.nlm.nih.gov]
Presents two brand-new chapters covering urinary cytology and fine needle aspiration to keep you up to date. Covers newly described entities and application of ancillary study for precise diagnosis. [books.google.de]
Google Scholar Handa U, Sood T, Punia RS: Testicular Leydig cell tumor diagnosed on fine needle aspiration. Diagn Cytopathol. 2010, 38: 682-684. 10.1002/dc.21306. [bmcresnotes.biomedcentral.com]
Urogenital
- Testicular Mass
Macroscopically, the testicular mass measured 3.0 x 2.3 x 1.5 cm and was well circumscribed. The cut surface was white to tan-gray in color. Neoplastic cells with eosinophilic cytoplasm proliferated with solid and tubular structures. [ncbi.nlm.nih.gov]
Diagnostic Work-up for Sex Cord-Stromal Tumors of the Testis Ultrasonography is the main investigation to be performed in any patient presenting with a testicular mass. It has a very high sensitivity for testicular tumors that can reach 100%. [lecturio.com]
Workup
Review Topic QID: 106375 5 No further workup, instruct patient to return if symptomatic M1 Select Answer to see Preferred Response PREFERRED RESPONSE 2 Sorry, this question is for PEAK Premium Subscribers only ARTICLES (4) VIDEOS (1) Topic COMMENTS (12 [medbullets.com]
Testicular Cancer Workup. Available online at http://emedicine.medscape.com/article/279007-overview. Accessed July 2014. Motzer RJ, Agarwal N, Beard C, et al. Testicular Cancer. [labtestsonline.it]
Treatment
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. [ncbi.nlm.nih.gov]
Treatment depends on the specific type of cancer. [cancer.org]
Treatment & Prognosis Radical orchiectomy is the initial treatment for Leydig cell tumors. [health.am]
Testicular Cancer (PDQ®): Treatment Patient Version. National Cancer Institute [On-line information]. Available online at http://www.cancer.gov/cancerinfo/pdq/treatment/testicular/patient/. (2006 July 24, Modified). [labtestsonline.it]
Prognosis
Seminoma late metastasis and excellent prognosis Embryonal worse prognosis than seminoma Choriocarcinoma worst prognosis in contrast to good prognosis in females metastasizes to lungs Please rate topic. [medbullets.com]
Germ cell tumors (germinoma, 90643; germ cell tumor, nonseminomatous, 90653) Seminoma (90613, 90623, 90663; most common 40-50%; slow to spread; more likely to occur in older patients; highly radiosensitive; good prognosis) Non-Seminoma (teratoma and embryonal [training.seer.cancer.gov]
[…] large cell subtype may present with multiple and bilateral mass with large areas of calcification MRI limited characterization in the literature, nonspecific appearance T2: homogeneously hypointense T1 C+ (Gd) : homogeneous enhancement Treatment and prognosis [radiopaedia.org]
Prognosis : good if tumor removed before metastasizes; better prognosis for scrotal testicle. Pathogenesis Pathophysiology About 25% estrogenic, especially if retained. (About 10-15% have blood dyscrasia). [vetstream.com]
Etiology
Etiology and Pathophysiology of Sex Cord-Stromal Tumors of the Testis Image : “Adolescent with Gynecomastia.” by David Andrew Copeland, Dr. Mordcai Blau www.gynecomastia-md.com – Own work. [lecturio.com]
Discussion The etiology of LCTs is unknown and it seems to be heterogeneous. Furthermore, the molecular basis of LCTs is poorly understood. Some studies showed a possible role of genetic factors in the etiology of this tumor. [bmcresnotes.biomedcentral.com]
Epidemiology
Leydig Cell Tumors Epidemiology & Pathology Leydig cell tumors are the most common non-germ cell tumors of the testis and account for 1-3% of all testicular tumors. [health.am]
Introduction Testicular tumors can be of germ cell or non-germ cell origin germ cell origin are the majority (95%) and are more commonly malignant non-germ cell origin usually benign Epidemiology incidence most common cancer in men between 15-35 years [medbullets.com]
Epidemiology Leydig cell tumours constitute 1-3% of all testicular tumours. Clinical features In children, they may present with isosexual pseudoprecocity. In adults, they present with a mass and/or gynaecomastia. [e-immunohistochemistry.info]
Definition / general Sex cord stromal tumor of testis composed of cells expressing, to a varying degree, features of fetal, prepubertal or adult Sertoli cells Terminology Also called androblastoma Epidemiology < 1% of testicular tumors Occurs in normally [pathologyoutlines.com]
Epidemiology of Sex Cord-Stromal Tumors of the Testis Sex cord-stromal tumors of the testis can be considered as the rarest form of testicular tumors. The most common form of testicular cancer is germ cell tumors. [lecturio.com]
Pathophysiology
Pathogenesis Pathophysiology About 25% estrogenic, especially if retained. (About 10-15% have blood dyscrasia). Incidence greatest in right testicle (cf cryptorchidism). 10% malignancy - metastasis to iliac, sublumbar, inguinal nodes. [vetstream.com]
Etiology and Pathophysiology of Sex Cord-Stromal Tumors of the Testis Image : “Adolescent with Gynecomastia.” by David Andrew Copeland, Dr. Mordcai Blau www.gynecomastia-md.com – Own work. [lecturio.com]
Prevention
Diagnosis This article is available in full to registered subscribers Sign up now to purchase a 30 day trial, or Login Treatment This article is available in full to registered subscribers Sign up now to purchase a 30 day trial, or Login Prevention This [vetstream.com]
It is necessary to establish preventive diagnostic strategies from an early age in these patients. Acknowledgments The authors thank Dr. M. Nistal, Department of Pathology, La Paz University Hospital, for providing histopathological assistance. [ibimapublishing.com]
Available online at https://www.cancer.org/cancer/testicular-cancer/causes-risks-prevention/risk-factors.html. Accessed on 2/13/18. (February 12, 2016) Testicular Cancer Survival Rates. American Cancer Society. [labtestsonline.it]