Macroorchidisms Secondary to Functioning Tumors during Childhood

Nistal, Manuel; González‐Peramato, Pilar; Serrano, Álvaro

doi:10.1007/978-3-319-49364-0_15

Cited by 1 publication

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“…The first indication that focal maturation of testicular parenchyma in the prepubertal patient could cause a testicular nodule appeared in the monograph, Testicular Tumors , in 1990, and was further mentioned as an ultrasonographic finding in the Armed Forces Institute of Pathology Atlas of Tumor Pathology: Tumors of the Testis, Adnexa, Spermatic Cord, and Scrotum in 1999 under the designation “nodular precocious maturation.”2,3 While this lesion has been mentioned anecdotally in those and additional textbooks,14 we have yet to find a report or study of it in the literature. Although “nodular precocious maturation” is an apt term for those cases that develop in young children, this phenomenon also affects boys who are likely experiencing the onset of normal, physiologic puberty, as exemplified by the 4 boys in our study who were 10 or 11 years old.…”

Section: Discussionmentioning

confidence: 96%

Nodular Maturation of the Testis

Przybycin

Williamson

Kao

et al. 2021

American Journal of Surgical Pathology

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We have encountered a lesion of the pediatric testis, termed “nodular maturation,” that clinically mimics a testicular neoplasm causing ultrasound abnormalities that may lead to surgical excision. To our knowledge, it has only been described anecdotally in textbooks without a series or description in the literature. We, therefore, report 8 cases in pediatric patients emphasizing the clinical presentation, ultrasound findings, histologic features, and clinical follow-up information. Patients ranged in age from 5 to 11 years (mean: 7.9 y). Precocious puberty was identified in 1 patient as isolated penile enlargement without other signs; another had a history of McCune-Albright syndrome, but did not have signs of precocious puberty; others had no clinical manifestations. All patients had testicular abnormalities on ultrasound; 6 had a discrete lesion and 2 showed diffuse testicular enlargement. In the 6 cases with available data, mean size of the lesion on ultrasound was 0.9 cm (range: 0.4 to 1.7 cm). In the 3 cases for which macroscopic descriptions were available, no gross abnormalities were noted in the testicular parenchyma, despite the ultrasound findings. Histologically, nodular maturation occurred as a zone of more mature testicular parenchyma having larger, lumen-bearing seminiferous tubules that contrasted with the smaller, immature cords of the remaining parenchyma. The mature tubules showed germ cell maturation (to the level of late spermatids/spermatozoa in 6 cases), mature Sertoli cells, and, in 4 cases, admixed nodules of mature Leydig cells. Of the 6 patients with available follow-up information, none developed a testicular neoplasm. Given its ability to cause a lesion on ultrasound leading to surgical intervention, pathologists, radiologists, and urologists should be aware of nodular maturation.

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Section: Discussionmentioning

confidence: 96%