Ivanis Sara, Marinkovic Milan, Jovanovic Milan, Buzejic Matija, Milinkovic Marija, Loncar Zlatibor, Zivaljevic Vladan, Rovcanin Branislav
Clinic for Endocrine Surgery, University Clinical Centre of Serbia, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Int J Endocrinol Metab. 2024 Oct 30;22(4):e156823. doi: 10.5812/ijem-156823. eCollection 2024 Oct.
Sertoli cell tumors are rare sex cord-stromal tumors, accounting for less than 1% of primary testicular tumors. They typically arise in the testes and ovaries, with other localizations being uncommon. We present the case of a Sertoli cell tumor in the adrenal gland, which, to our knowledge, is the first reported in the literature.
A 44-year-old male patient was admitted to the clinic for endocrine surgery for laparoscopic surgery of a right adrenal gland incidentaloma measuring 57 × 47 × 59 mm, discovered during a routine abdominal ultrasonography. The patient had a history of hypertension but no other comorbidities. Biochemical and physical examinations revealed no signs of hypercortisolism. Urinary metanephrine and normetanephrine levels were within normal limits. A right laparoscopic adrenalectomy was performed, and a 5 cm tumor was identified without evidence of locoregional invasion. Pathological examination confirmed a Sertoli cell tumor of the adrenal gland. Immunohistochemical analysis revealed positive staining for vimentin, steroidogenic factor 1 (SF1), and beta-catenin, while chromogranin A, hCG, PSA, and TTF1 were negative. The Ki-67 index was 3%. The patient was subsequently referred to a urologist, where testicular ultrasonography showed no abnormalities. There were no signs of recurrence during a 15-month follow-up period. Additionally, the patient's biannual antihypertensive treatment was discontinued by a cardiologist 1.5 months post-surgery.
Sertoli cell tumors are an exceptionally rare entity. To our knowledge, this is the first reported case of a primary Sertoli cell tumor originating in the adrenal gland. Given their potential for malignancy, regular follow-up and additional diagnostic evaluations may be necessary. Laparoscopic adrenalectomy appears to be a suitable definitive treatment for this condition.
支持细胞瘤是一种罕见的性索间质肿瘤，占原发性睾丸肿瘤的比例不到1%。它们通常发生于睾丸和卵巢，其他部位则较为罕见。我们报告一例肾上腺支持细胞瘤，据我们所知，这是文献中首次报道的病例。
一名44岁男性患者因内分泌外科手术入院，接受腹腔镜下右侧肾上腺意外瘤切除术，该意外瘤是在常规腹部超声检查中发现的，大小为57×47×59mm。患者有高血压病史，但无其他合并症。生化和体格检查未发现皮质醇增多症的迹象。尿间甲肾上腺素和去甲间肾上腺素水平在正常范围内。进行了右侧腹腔镜肾上腺切除术，发现一个5cm的肿瘤，无局部区域侵犯的证据。病理检查证实为肾上腺支持细胞瘤。免疫组化分析显示波形蛋白、类固醇生成因子1（SF1）和β-连环蛋白呈阳性染色，而嗜铬粒蛋白A、人绒毛膜促性腺激素、前列腺特异性抗原和甲状腺转录因子1呈阴性。Ki-67指数为3%。患者随后转诊至泌尿科医生处，睾丸超声检查未发现异常。在15个月的随访期内未出现复发迹象。此外，术后1.5个月，心脏病专家停止了患者每半年一次的抗高血压治疗。
支持细胞瘤是一种极其罕见的疾病。据我们所知，这是首例起源于肾上腺的原发性支持细胞瘤报道。鉴于其潜在的恶性可能性，可能需要定期随访和进一步的诊断评估。腹腔镜肾上腺切除术似乎是治疗这种疾病的合适的确定性治疗方法。
