Testis and epididymis
Sex cord stromal tumors
Adult granulosa cell tumor

Author: Swapnil U. Rane, M.D. (see Authors page)

Revised: 17 July 2017, last major update July 2013

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PubMed Search: Adult granulosa cell tumor testis

Related topics: Juvenile granulosa cell tumor

Cite this page: Adult granulosa cell tumor. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/testisgranulosa.html. Accessed August 17th, 2017.
Definition / general
  • Tumor with cells resembling the granulosa cells of ovary
Epidemiology
  • Rare
  • Average age at presentation 44 years
Clinical features
  • Usually slow growing, nonfunctional testicular mass
  • Gynecomastia in 25%
  • Also elevated serum inhibin (like other sex cord stromal tumors), elevated serum Müllerian inhibiting hormone (like ovarian granulosa cell tumors)
  • Usually benign; metastases in 10 - 20% (see prognostic factors)
Radiology description
  • Not specific - cannot differentiate between benign and malignant tumor
Radiology images

Images hosted on other servers:

MRI

Prognostic factors
Case reports
Treatment
  • Radical orchiectomy
  • Enucleation can be attempted if tumor is small and there is no evidence of metastases at presentation
Gross description
  • Microscopic to 13 cm in diameter (average 5 cm)
  • Circumscribed, sometimes encapsulated
  • Yellow, solid cut surface, may have small cysts
  • Necrosis and hemorrhage are unusual
Gross images

Images hosted on other servers:

Sagital section of testis

Microscopic (histologic) description
  • Most common patterns are microfollicular and diffuse
  • Other patterns
    • Trabecular
    • Macrofollicular
    • Gyriform
    • Pseudosarcomatous
  • Call-Exner bodies (central eosinophillic material, around which cells are arranged): most commonly seen with microfollicular pattern
  • Round to oval nuclei with nuclear grooving (coffee bean nuclei) and peripherally placed multiple nucleoli
  • Commonly thecomatous differentiation
  • Smooth muscle or osteoid differentiation may also be seen
  • No / rare mitoses (unlike the juvenile type), pleomorphism, necrosis
Microscopic (histologic) images

Images hosted on other servers:

Various images

Call-Exner Bodies


Round to oval nuclei

Trabecular and diffuse pattern

CD99 / MIC2

Calretinin

Positive stains
Electron microscopy description
  • Dual epithelial - smooth muscle differentiation, similarity to primitive Sertoli cells and pre-ovulatory granulosa cells
  • Granulosa cells with continuous basal lamina, cytoplasmic filaments with evenly distributed dense bodies resembling smooth muscle (Am J Surg Pathol 1996;20:72)
Molecular / cytogenetics description
  • No specific genetic abnormality identified but most studies performed on juvenile granulosa cell tumors