Testis & epididymis
Sex cord-stromal tumors
Sertoli cell sclerosing
Author: Swapnil U. Rane, M.D.
Topic Completed: 1 January 2014
Minor changes: 10 September 2020
Copyright: 2003-2020, PathologyOutlines.com, Inc.
PubMed Search: Sclerosing sertoli cell tumor of the testis
Table of Contents
Definition / general | Epidemiology | Sites | Clinical features | Radiology description | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Immunohistochemistry | Differential diagnosis | Additional referencesCite this page: Rane S. Sertoli cell sclerosing. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testissclerosingsertoli.html. Accessed September 19th, 2020.
Definition / general
- First described by Zukerberg et. al. (Am J Surg Pathol 1991;15:829)
- Sertoli cell tumor with extensive areas of sclerosis
- Important to identify because of benign behavior / better prognosis than Sertoli cell tumor NOS and large cell calcifying variant
Epidemiology
- Rare
- Age range 18 - 80 years (mean age 35 years) (Scand J Urol Nephrol 1999;33:197)
- No syndromic associations reported (unlike Sertoli cell tumor NOS associated with Peutz-Jegher syndrome or large cell calcifying variant of Sertoli cell tumor associated with Carney complex)
Sites
- Normally descended testis
- Usually unilateral
- Occur equally in both testes
Clinical features
- Usually presents with asymptomatic mass in the testis
- These tumors are hormonally inactive and gynecomastia is rare (25% of cases of Sertoli cell NOS are associated with gynecomastia)
Radiology description
- Not specific
- Well circumscribed hypo - echoic lesion
Case reports
- 23 year old man (Case #18)
- 33 year old man (Pathol Res Pract 2012;208:121)
- 35 year old man (J Urol 1995;154:1756)
- 38 year old man (Anticancer Res 2012;32:5127)
- Case reports: Scand J Urol Nephrol 1999;33:197, J Coll Physicians Surg Pak 2005;15:437
Treatment
- Most patients are treated with high inguinal orchidectomy
- There is no role of chemotherapy or radiotherapy
- No recurrence or progression has been reported
Gross description
- Small (< 2 cm), well circumscribed nodule
- Cut surface is hard, yellow, white, tan
- Usually no hemorrhage or necrosis
Microscopic (histologic) description
- Sertoli cells arranged in well formed tubules, cords or irregular aggregates, separated by extensive hypocellular, collagenous stroma
- Distinguish from focal sclerosis in Sertoli cell - NOS and large cell calcifying Sertoli cell tumors
Microscopic (histologic) images
Case #18
Images hosted on other servers:
Sclerosing Sertoli cell tumor
Immunohistochemistry
- Sex cord stromal markers are usually positive, including calretinin, inhibin, vimentin
- Cytokeratins are usually negative, with occasinal exceptions (Pathol Res Pract 2012;208:121)
- AFP and β-hCG are negative
Differential diagnosis
- Adenomatoid tumor: extra - testicular tumor, inhibin negative
- Large cell calcifying Sertoli cell tumor: presence of extensive calcification
- Metastatic carcinoma: cytokeratin positive
- Sertoli cell tumor NOS: lack of extensive sclerosis, associated with Peutz-Jegher syndrome
