Large Cell Calcifying Sertoli Cell Tumor of the Testis: A Case Study and Review of the Literature

Abstract

A 24-year-old man was admitted due to an incidentally detected mass in his left testis, which showed radiopaque calcification on plain X-ray film. Left orchiectomy was performed, and the resected testis contained a well-demarcated, hard mass measuring 1.1 cm. Histological analysis revealed that the tumor was composed of neoplastic cells, fibrotic stroma, and laminated or irregularly shaped calcific bodies. The individual cells had abundant eosinophilic or clear cytoplasm with round nuclei, each of which contained one or two conspicuous nucleoli. They were arranged in cords, trabeculae, clusters, and diffuse sheets. There were several foci of intra-tubular growth patterns, with thickening of the basal lamina. Immunohistochemically, the neoplastic cells were positive for S-100 protein and vimentin, focally positive for inhibin alpha, and negative for cytokeratin, CD10, and Melan-A. In addition to reporting this rare case, we also review the relevant literature regarding large cell calcifying Sertoli cell tumors.

A Comprehensive Review of Pediatric Tumors and Associated Cancer Predisposition Syndromes

“…The cumulative risk of testicular cancer in PJS has been reported to be 9% (van Lier et al 2010) with a mean age of onset of 8.7 years (range 3-20) (Beggs et al 2010). About 50% of males with Carney complex will develop LCCSCT (Song et al 2014). Most occur post puberty but range in age of diagnosis from 2 to 51 years (Courcoutsakis et al 2013).…”

Large-cell calcifying sertoli cell tumor of the testis

“…It is frequently bilateral, multifocal, and rarely shows metastasis. While 60% of the reported cases are sporadic, 40% of the cases are associated with genetic abnormalities such as Carney complex and Peutz-Jeghers syndrome 4,8 . Histopathologically, LCCSCT involves cuboidal or columnar sertoli cells with prominent nucleoli, abundant eosinophilic cytoplasm, and generally cytoplasmic vacuoles, embedded in a myxohyaline stroma.…”

“…Treatment includes radical orchiectomy and lymph node dissection is performed if retroperitoneal lymph node involvement. Currently there is no standard role for chemo-radiotherapy 8,9 . The present case had undergone orchiectomy and close follow-up was recommended, due to malignant potential because of the presence of necrosis and mitotic activity.…”

Medical and Surgical Management of Carney Complex

“…Biochemical analysis includes follicular‐stimulating hormone, luteinizing hormone, and gonadotropin‐releasing hormone levels. Ultrasound is desired for imaging, although radiographic films have been used for detection . Ultrasound and detection of multiple “Christmas‐tree like” lesions and calcifications suggests LCCSCT.…”

“…Ultrasound is desired for imaging, although radiographic films have been used for detection. 61,85,86 Ultrasound and detection of multiple ''Christmas-tree like'' lesions and calcifications suggests LCCSCT. Medical therapy is sufficient to control precocious puberty or gynecomastia.…”