Claros Oliver Rojas, Sakai Américo Toshiaki, Consolmagno Horácio, Nogueira Marcos de Paula, Testagrossa Leonardo Abreu, Fugita Oscar Eduardo Hidetoshi
Department of Surgery - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Department of Pathology - Hospital das Clinicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil.
Autops Case Rep. 2014 Mar 31;4(1):39-44. doi: 10.4322/acr.2014.006. eCollection 2014 Jan-Mar.
Testicular neoplasms are uncommon tumors of childhood. These tumors comprise the germ cell tumors, and other tumors that may originate from histological testicular components, which are unrelated to the germinal lineage. Among the latter are the sex cord-stromal tumors (SCST), an important entity in newborns. SCSTs comprise, among others, granulosa cell tumors, which are more common in the ovary, but in rare cases may develop in the testis. The prognosis is excellent since it is universally benign. Diagnosis, which is sometimes challenging, is usually made after orchiectomy and pathological examination, which is characterized by morphological features and positive expression of inhibin, calretinin, and vimentin, and negative for alpha-fetoprotein. The authors present the case of a newborn with a right enlarged testis detected during the first examination after birth. Ultrasonography showed a heterogeneous solid/cystic mass in the right testis, without retroperitoneal lymphadenopathy. A right inguinal orchiectomy was performed 21 hours after birth. Pathologic examination revealed a juvenile granulosa cell tumor of the right testicle. After 4 years of follow-up, as expected, the child presented an uneventful outcome.
睾丸肿瘤是儿童期罕见的肿瘤。这些肿瘤包括生殖细胞肿瘤，以及其他可能起源于睾丸组织学成分且与生殖系无关的肿瘤。后者包括性索间质肿瘤（SCST），这是新生儿中的一个重要类型。SCST包括颗粒细胞瘤等，颗粒细胞瘤在卵巢中更常见，但在罕见情况下可发生于睾丸。其预后极佳，因为它普遍为良性。诊断有时具有挑战性，通常在睾丸切除术后经病理检查做出，其特征为具有形态学特征，抑制素、钙视网膜蛋白和波形蛋白呈阳性表达，甲胎蛋白呈阴性。作者报告了一例新生儿病例，该新生儿在出生后的首次检查中发现右侧睾丸肿大。超声检查显示右侧睾丸有一个不均匀的实性/囊性肿块，无腹膜后淋巴结肿大。出生后21小时进行了右侧腹股沟睾丸切除术。病理检查显示右侧睾丸为幼年型颗粒细胞瘤。经过4年的随访，不出所料，该患儿预后良好。
