Testicular Fibrothecoma

Abstract

Benign intratesticular spindle cell lesions are rare. Herein, we report the morphology, immunohistochemical characteristics, and prognosis of 16 cases of testicular fibrothecoma. The mean age at diagnosis was 44 years (16 to 69 y). Of 15 patients with information, 14 presented with a palpable testicular mass and 1 with heaviness in the scrotum. Medical histories included bilateral orchidopexy as a child (n=1) and testicular atrophy receiving testosterone replacement (n=1). The average size was 1.8 cm (median 2 cm; range, 0.5 to 7.6 cm). All cases were intratesticular, although 13 were abutting the tunica albuginea with others centered on the rete testis (n=2), or were indeterminate on biopsy (n=1). Eleven cases were relatively well circumscribed, although not encapsulated, with 1 being infiltrative and 4 not evaluable. Four tumors showed entrapment of seminiferous tubules. Half of the fibrothecomas showed a mixed storiform pattern and short fascicles, with 6 storiform only and 2 short fascicles only. One half of the tumors were very hypercellular. Cases were equally split between having plumper ovoid as opposed to spindled pointed nuclei, with all cases lacking prominent nucleoli. Eleven cases had 0 to 2 mitoses per 10 HPF, 3 had 4 to 5 mitoses per 10 HPF, and 2 had 9 to 10 mitoses per 10 HPF. Collagen deposition either in bands or investing single cells ranged from none to extensive, with 10/16 cases having at least a moderate amount. Immunohistochemical positivity was as follows: inhibin (11/13, patchy to diffuse); calretinin (5/9); Melan-A (4/4); pan keratin (5/8); BCL2 (3/4); CD34 (3/8); S100 (4/8); muscle-specific actin (4/4); and desmin (5/8). Patients were followed up for a mean of 71.8 months (range, 3 to 144 mo). All were well with no evidence of disease. Of the 2 men with 9 to 10 mitoses per 10 HPF, 1 died of other causes 5 years and 8 months later, and the other had no evidence of disease at 4 years and 10 months after surgery. In summary, testicular fibrothecomas are rare with somewhat variable histology and can have worrisome histologic features such as minimal invasion into surrounding testis, high cellularity, and increased mitotic rate. Their immunoprofile is variable and typically not diagnostic. Despite some worrisome histologic features, they appear uniformly benign in their behavior.

Effect of educational guidelines based on health belief model regarding testicular cancer knowledge, practice and beliefs among male nursing students

“…Planning phase: The content of the educational guidelines about testicular cancer and TSE were prepared by the researchers based on the related literature. [41][42][43][44][45] Objectives of the study were prepared based on the needs of the study students. An illustrative structured booklet was prepared and supported by pictures as a guide for the students, and different teaching methods were used as lectures, discussions, demonstration and redemonstration.…”

Immunohistochemical Characterization of 120 Testicular Sex Cord-Stromal Tumors With an Emphasis on the Diagnostic Utility of SOX9, FOXL2, and SF-1

“…A subset of these tumors was included in previously published studies. 8,[30][31][32] All cases were reviewed, and diagnoses, according to the 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs, 1 were confirmed (Table 1). All available IHC stains were reviewed and documented.…”

“…Inhibin α, calretinin, and Wilms' tumor 1 (WT1) are commonly used immunohistochemical (IHC) stains for confirming sex cord-stromal differentiation in both testicular and ovarian neoplasms, and the staining characteristics for these markers are similar when comparing SCSTs common to the testis and ovary. [2][3][4][5][6][7][8][9][10][11][12] Calretinin has been reported to be a more sensitive but less specific stain than inhibin α for SCSTs, and both calretinin and inhibin α appear to be overall more sensitive than WT1. 3,[9][10][11][12] The diagnostic utility of inhibin α, calretinin, and WT1 for subclassifying SCSTs is limited, as they produce substantial immunophenotypic overlap between entities and have suboptimal sensitivity for certain tumor categories.…”

“…3,[9][10][11][12] The diagnostic utility of inhibin α, calretinin, and WT1 for subclassifying SCSTs is limited, as they produce substantial immunophenotypic overlap between entities and have suboptimal sensitivity for certain tumor categories. [2][3][4][5][6][7][8][9][10][11][12] SRY-box transcription factor 9 (SOX9), forkhead box protein L2 (FOXL2), and steroidogenic factor 1 (SF-1), which is encoded by the nuclear receptor subfamily 5 group A member 1 (NR5A1) gene, are 3 important gene products in human gonadal development. SOX9 is activated by sex-determining region Y to initiate testicular development and does so along with SF-1.…”

Adult testicular granulosa cell tumour: an extremely rare entity

“…The differential diagnosis of the adult GCT still includes the fibrothecoma, that appear at the same median age8 and are composed of ovoid and/or spindled cells in varying amounts of collagenous stroma which may mimic adult GCT containing a spindled and/or fibrosarcoma-like pattern 3 9…”