Case Report of Misleading Features of a Rare Sertoli Cell Testicular Tumor

Abstract

Testicular Sertoli cell tumors are extremely rare. Generally, they are benign neoplasms, which belong to a group called sex cord–stromal tumors. In this article, we present a case report of a Sertoli cell tumor, which was accidentally discovered during a urological consultation of a 42-year-old male. An ultrasound showed a 2.1 × 2.2 cm hypoechogenic, hypervascular tumor in the middle third of the left testicle. Serum tumor markers (α-fetoprotein, alkaline phosphatase, β-human chorionic gonadotropin, and lactic dehydrogenase) were all within the normal range. Rapid microscopic evaluation of fresh frozen sections during the operation was inconclusive, which led to a decision not to perform a radical orchiectomy immediately. On formalin-fixed paraffin-embedded (FFPE) sections, the tumor histology showed atypical patterns, and immunohistochemical analysis was performed in order to determine the type of neoplasm and differentiate it from other types of testicular tumors, so as to assign the further course of treatment. Radical inguinal orchiectomy was performed. The final pathology report showed a tumor with no predictive signs of aggressive behavior, which most closely resembled a Sertoli cell tumor.

Sertoli Cell Testicular Tumor: A Case Report

“…Sertoli cell tumors are mostly of benign characters; however, an in-depth literature analysis shows cases with malignant behavior. Generally, the aggressive attitude was estimated to be observed in 10-22% of these tumors (11). Sertoli cell testicular tumors are rarely observed, thus no strict follow-up and treatment protocols are available.…”

“…However, various aggressive treatment strategies, such as retroperitoneal lymph node dissection, chemotherapy, and radiation therapy combinations, are applied in cases that show remote organ dissemination (13). Survival rates for 1 and 5 years were estimated as 93 and 77% for Stage 1 Sertoli cell tumors, respectively (11). Contrarily, late metastases were reported in some cases at stages up to 10 years (14).…”