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Presented by Dr. Ezra Baraban and prepared by Dr. Sintawat Wangsiricharoen.
A 20-year-old man with a testicular mass.
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1. Question
A 20-year-old man with a testicular mass. Choose the correct diagnosis:
Correct
Answer: B. Sclerosing Sertoli cell tumor.
Sections show a low grade neoplasm composed of cords and strands of bland cells within a dense collagenous stroma, between seminiferous tubules. The morphology does not fit with any established germ cell tumor subtype. The oval nuclei and delicate central nucleoli are typical of Sertoli cell tumor. The corded architecture raises adenomatoid tumor, but the entirely intratesticular location essentially excludes that diagnosis. The lack of speckled chromatin and dense collagenous stroma would be somewhat unusual for a carcinoid/neuroendocrine tumor, either primary or metastatic. Reactivity for SF1 would confirm sex-cord differentiation, and in combination with this morphology is diagnostic of a sclerosing sertoli cell tumor, a morphologic variant of sertoli cell tumor, which is divided into the NOS, sclerosing, large cell calcifying, and intratubular hyalinizing sertoli cell neoplasia categories.
Incorrect
Answer: B. Sclerosing Sertoli cell tumor.
Sections show a low grade neoplasm composed of cords and strands of bland cells within a dense collagenous stroma, between seminiferous tubules. The morphology does not fit with any established germ cell tumor subtype. The oval nuclei and delicate central nucleoli are typical of Sertoli cell tumor. The corded architecture raises adenomatoid tumor, but the entirely intratesticular location essentially excludes that diagnosis. The lack of speckled chromatin and dense collagenous stroma would be somewhat unusual for a carcinoid/neuroendocrine tumor, either primary or metastatic. Reactivity for SF1 would confirm sex-cord differentiation, and in combination with this morphology is diagnostic of a sclerosing sertoli cell tumor, a morphologic variant of sertoli cell tumor, which is divided into the NOS, sclerosing, large cell calcifying, and intratubular hyalinizing sertoli cell neoplasia categories.
