Sun Mingfang, Liu Yang, Yu Juanhan, Diao Kexin, Zhang Jie, Qiu Xueshan, Mi Xiaoyi, Wang Jian
Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China.
Transl Androl Urol. 2020 Dec;9(6):2836-2841. doi: 10.21037/tau-20-795.
Testicular sex cord-stromal tumors are less common in men, while mixed sex cord-stromal tumors (MSCSTs) are rarer. Recently, we found a MSCST in an adult male testis [adult granulosa cell tumor (AGCT) with Sertoli cell tumor]. He was admitted to the hospital based on "left testicular bloating and dull pain for 20 years and aggravating for 10 days". Routine examination of color Doppler ultrasound showed a size of approximately 1.09 cm × 0.79 cm in the left testis with a low echo area, clear outline, and color flow in it. The patient underwent a radical left orchiectomy to remove the tumor. Pathological results showed that the tumor was diagnosed as testicular MSCST (AGCT with Sertoli cell tumor). He was in good health after the operation and showed no signs of recurrence or metastasis after 6 months of follow-up. We summarized the clinical, ultrasonic, and histopathological characteristics of this case. And immunohistochemical staining was very important in the pathological diagnosis of testicular MSCSTs, which can distinguish different tumor types. MSCSTs were usually mixed Sertoli-Leydig cell tumors, while this case is a MSCST of AGCT with Sertoli cell tumor, which is unique from other cases. Moreover, in this case, the doctors could not clearly diagnose the tumor through pre-operative physical, ultrasonic and laboratory examinations until the postoperative pathological examination. This further reflected the importance of pathological examination in the diagnosis of such tumors.
睾丸性索间质肿瘤在男性中较为少见，而混合性性索间质肿瘤（MSCSTs）则更为罕见。最近，我们在一名成年男性睾丸中发现了一例MSCST（成人颗粒细胞瘤[AGCT]合并支持细胞瘤）。他因“左侧睾丸坠胀、隐痛20年，加重10天”入院。彩色多普勒超声常规检查显示左侧睾丸大小约为1.09 cm×0.79 cm，有低回声区，边界清晰，内部有血流信号。患者接受了左侧睾丸根治性切除术以切除肿瘤。病理结果显示该肿瘤被诊断为睾丸MSCST（AGCT合并支持细胞瘤）。术后他身体状况良好，随访6个月无复发或转移迹象。我们总结了该病例的临床、超声和组织病理学特征。免疫组化染色在睾丸MSCSTs的病理诊断中非常重要，它可以区分不同的肿瘤类型。MSCSTs通常是混合性支持-间质细胞瘤，而该病例是AGCT合并支持细胞瘤的MSCST，与其他病例不同。此外，在该病例中，直到术后病理检查医生才能通过术前体格检查、超声检查和实验室检查明确诊断肿瘤。这进一步体现了病理检查在这类肿瘤诊断中的重要性。
