Harms D, Kock L R
Department of Paediatric Pathology, Kiel, Germany.
Virchows Arch. 1997 Apr;430(4):301-9. doi: 10.1007/BF01092753.
Testicular Sertoli cell tumours (SCT) and juvenile granulosa cell tumours (JGCT) are rare in childhood. This study was designed to investigate the clinical picture, morphology and disease course in a comparatively large series of cases (total number = 29). Of 198 cases of childhood testicular tumour documented in the Kiel Paediatric Tumour Registry 18 were cases of infantile SCT (9.1%) and 11 of JGCT (5.6%). The average age at the time of diagnosis was 4.2 months for infantile SCT and 0.4 months for IGCT. SCT and JGCT often showed infiltrative growth into adjacent testicular tissue, dense cellularity and considerable proliferation activity. Immunohistochemically all cases expressed vimentin intermediate filaments in both tumour types. Next in frequency of expression were cytokeratins (SCT: 7/16; JGCT: 7/10) and smooth-muscle actin (SCT: 9/15; JGCT: 4/10). Follow-up studies (24/29) showed that in cases of tumour manifestation in infancy and after complete tumour removal (usually orchiectomy) no local recurrences and no metastases occurred. The most important conclusion for diagnosis and therapy is that despite infiltrative growth, incomplete differentiation, dense cellularity and considerable proliferation activity, after surgical excision infantile SCT and JGCT have a good prognosis. Adjuvant chemotherapy or more extensive operations with lymphadenectomy are thus not indicated.
睾丸支持细胞瘤(SCT)和幼年型颗粒细胞瘤(JGCT)在儿童期较为罕见。本研究旨在调查一系列相对较大病例(总数 = 29 例)的临床表现、形态学及疾病进程。在基尔儿科肿瘤登记处记录的 198 例儿童睾丸肿瘤中,18 例为婴儿型 SCT(9.1%),11 例为 JGCT(5.6%)。婴儿型 SCT 诊断时的平均年龄为 4.2 个月,IGCT 为 0.4 个月。SCT 和 JGCT 常表现为向相邻睾丸组织浸润性生长、细胞密集及显著的增殖活性。免疫组化显示,两种肿瘤类型的所有病例均表达波形蛋白中间丝。其次表达频率较高的是细胞角蛋白(SCT:7/16;JGCT:7/10)和平滑肌肌动蛋白(SCT:9/15;JGCT:4/10)。随访研究(24/29)表明,对于婴儿期出现肿瘤且肿瘤完全切除(通常为睾丸切除术)的病例,未发生局部复发和转移。诊断和治疗的最重要结论是,尽管婴儿型 SCT 和 JGCT 有浸润性生长、分化不完全、细胞密集及显著增殖活性,但手术切除后预后良好。因此,无需进行辅助化疗或更广泛的包括淋巴结清扫术的手术。