Kao Chia-Sui, Ulbright Thomas M
From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis.
Am J Clin Pathol. 2014 Nov;142(5):675-82. doi: 10.1309/AJCPGSCD1DGNZ0QO.
To report three new cases of testicular myoid gonadal stromal tumor to better characterize its features.
The clinicopathologic findings (including follow-up) were evaluated and a review of the literature was performed.
The patients were 38, 43, and 59 years old, and tumor sizes were 1.2, 1.3, and 3.2 cm. All were unilateral, well circumscribed, adjacent to the rete testis, and composed exclusively of spindled cells with elongated nuclei and occasional nuclear grooves arranged in fascicles with admixed variably ectatic blood vessels. Nucleoli were inconspicuous, and the cytoplasm was scant, ill-defined, and pale/lightly eosinophilic. No sex cord component was present. Mitotic figures ranged from zero to five per 10 high-power fields. Significant atypia, lymphovascular invasion, and necrosis were absent. All were consistently positive for smooth muscle actin, S100 protein, FOXL2, and steroidogenic factor 1 but negative for h-caldesmon, calretinin, and SOX9. Inhibin and calponin were focally positive. All patients were alive and well at 5, 31, and 58 months postorchiectomy. Combining our cases with those previously reported (n = 6) shows that this neoplasm occurs mostly in younger men (mean, 37 years), and all follow-up thus far (mean, 25 months) has been benign.
Myoid gonadal stromal tumors are small (<4 cm) indolent testicular tumors distinctly different from other sex cord-stromal tumors and are adequately managed by orchiectomy.
报告3例睾丸肌样性腺间质瘤新病例，以更好地描述其特征。
评估临床病理特征（包括随访情况）并进行文献复习。
患者年龄分别为38岁、43岁和59岁，肿瘤大小分别为1.2 cm、1.3 cm和3.2 cm。所有肿瘤均为单侧，边界清晰，毗邻睾丸网，仅由梭形细胞组成，细胞核细长，偶见核沟，呈束状排列，伴有不同程度扩张的血管。核仁不明显，细胞质稀少，边界不清，淡染/轻度嗜酸性。无性索成分。每10个高倍视野的有丝分裂象为0至5个。无明显异型性、脉管浸润及坏死。所有病例平滑肌肌动蛋白、S100蛋白、FOXL2和类固醇生成因子1均持续阳性，而h - 钙调蛋白、钙视网膜蛋白和SOX9均为阴性。抑制素和钙调磷酸酶局灶性阳性。所有患者在睾丸切除术后5个月、31个月和58个月时均存活且情况良好。将我们的病例与先前报道的病例（n = 6）合并分析显示，该肿瘤多发生于年轻男性（平均37岁），目前所有随访（平均25个月）均显示为良性。
肌样性腺间质瘤是一种较小（<4 cm）的惰性睾丸肿瘤，与其他性索间质肿瘤明显不同，睾丸切除术可有效治疗。
