Angerer Markus, Wülfing Christian, Gübitz Raphael, Harms Alexander, Dieckmann Klaus-Peter
Department of Urology, Asklepios Klinik Altona, Hamburg, DEU.
Department of Radiology, Asklepios Klinik Altona, Hamburg, DEU.
Cureus. 2023 Jul 9;15(7):e41614. doi: 10.7759/cureus.41614. eCollection 2023 Jul.
Large-cell calcifying Sertoli cell tumor (LCCST) is a rare, testicular sex cord, gonadal stromal tumor that belongs to the histological subgroup of Sertoli cell tumors. LCCSTs may involve malignant potential. However, metastasis is a rare phenomenon. We describe a case of benign late-onset LCCST with testis-sparing surgery. Modern imaging techniques were useful for considering organ-sparing surgery. The ultrasound of a 37-year-old man disclosed a sharp demarcated and strong hyper-echoic lesion sized 1.5 cm, with broad dorsal acoustic shadowing. Testicular tumor markers, including lactate dehydrogenase (LDH), alpha-fetoprotein (AFP), and Beta-human chorionic gonadotropin (ß-HCG) did not reveal any pathological finding. Contrast-enhanced MRI of the pelvis showed a ring-shaped tumor with a strong contrast medium enhancement. Sections of the tumor showed a hard mass with a white calcified ring. A frozen section examination of the testicular tumor did not indicate malignancy. Histologic examination revealed a prominent and noticeable calcification of approximately 3 mm thickness. Tumor cells presented in the form of solid nests, tubules, and cords. Our present case differs from previously reported LCCST cases because the tumor was unilateral, smaller in size, and presented in an older patient.
大细胞钙化性支持细胞瘤（LCCST）是一种罕见的睾丸性索、性腺间质肿瘤，属于支持细胞瘤的组织学亚组。LCCST可能具有恶性潜能。然而，转移是一种罕见现象。我们描述了一例采用保留睾丸手术治疗的良性迟发性LCCST病例。现代成像技术有助于考虑保留器官手术。一名37岁男性的超声检查发现一个边界清晰、强回声的病变，大小为1.5厘米，伴有明显的后方声影。包括乳酸脱氢酶（LDH）、甲胎蛋白（AFP）和β-人绒毛膜促性腺激素（β-HCG）在内的睾丸肿瘤标志物未发现任何病理结果。盆腔增强MRI显示一个环形肿瘤，有强烈的造影剂增强。肿瘤切片显示为一个有白色钙化环的硬块。睾丸肿瘤的冰冻切片检查未显示恶性。组织学检查显示有一个厚度约为3毫米的明显钙化。肿瘤细胞呈实性巢状、小管状和条索状。我们目前的病例与先前报道的LCCST病例不同，因为该肿瘤是单侧的，体积较小，且发生在老年患者身上。
