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Table of Contents
Definition / general | Epidemiology | Pathophysiology | Clinical features | Radiology description | Prognostic factors | Case reports | Treatment | Clinical images | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Molecular / cytogenetics description | Differential diagnosisCite this page: Osteosarcoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/testisosteosarcoma.html. Accessed July 15th, 2017.
Definition / general
- A testicular tumor composed of pure osteoid forming malignant cells with no skeletal origin
Epidemiology
- Pure testicular osteosarcoma is exceptionally rare
- Case reports: mean 59 years, range 30 - 78 years
Pathophysiology
- Usually derive from sarcomatous transformation of germ cell tumors (teratoma)
- May also occur as a component of malignant mixed sex cord / stromal tumor
- Pure osteosarcomas without teratomatous elements have also been reported; may arise from primitive testicular stromal cells or metaplastic stromal cells (Virchows Arch 2004;445:210, Int J Urol 2006;13:323)
Clinical features
- Scrotal mass
Radiology description
- Intratesticular heterogeneous solid mass with focal calcification
Prognostic factors
- Organ confined disease is associated with a favorable prognosis
Case reports
- 30 and 86 year old men with primary testicular sarcoma (Hum Pathol 1990;21:932)
- 60 year old man (Int J Urol 2006;13:323)
- 78 year old man with hydrocele (Virchows Arch 2004;445:210)
- Osteosarcoma of the testis (Arch Pathol Lab Med 1981;105:38)
Treatment
- Orchiectomy
Clinical images
Images hosted on other servers:
Left testicular mass almost entirely calcified
Gross description
- Well circumscribed, solid, firm, whitish tan, expansile mass compressing the surrounding testicular parenchyma
Gross images
Images hosted on other servers:
Off white colored tumor
Microscopic (histologic) description
- Sheets of pleomorphic round to spindled cells with prominent nucleoli
- Areas of neoplastic osteoid with scattered foci of mineralization
- High mitotic activity and atypical mitoses
- Osteoclasts can be seen among the area of osteoid formation
Microscopic (histologic) images
Images hosted on other servers:
Sarcomatous cell proliferation - H&E
Molecular / cytogenetics description
- Rearrangement of p53 gene at 17p13 may be important in oncogenesis of osteosarcoma (Int J Urol 2006;13:323)
Differential diagnosis
- Metastatic osteosarcoma
- Sex cord / stromal tumor with sarcomatous transformation
- Teratoma with sarcomatous transformation
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