Cases reported "Sertoli Cell Tumor"

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1/22. Ovarian sex cord tumor with annular tubules--a case report and review of the literature in Japanese.

    A case of ovarian sex cord tumor with annular tubules (SCTAT) in a 41-year-old female is reported. The patient's chief complaint was menstrual irregularity, but the serum values of estradiol and testosterone were not elevated. On gross examination, the left ovary measured 8 x 7 x 6 cm in size and its cut surface was yellowish gray or yellow and solid with no cystic area. Histologically, the tumor was composed of simple and complex annular tubules, lined by columnar cells containing abundant lipid droplets. Eosinophilic materials in the center of the annular tubules were continuous with the basement membrane in the periphery, and showed immunoreactivity for type IV collagen. Also, hollow tubules, consisting of columnar cells with a truncated luminal surface and elongated trabeculae, composed of columnar cells with clear cytoplasm, were noted. These structures were reminiscent of sertoli cell tumor. Based on these histological observations, it appears that SCTAT is a sex cord/stromal tumor made up of cells with differentiation in the direction of sertoli cells rather than granulosa cells.
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2/22. Fine needle aspiration cytology in malignant sertoli cell tumor of the testis. A case report.

    A rare case of malignant sertoli cell tumor of the testis occurred in which the diagnosis was initially suggested on fine needle aspiration cytology. Smears of the testicular, inguinal and cervical lymph node aspirates showed cells resembling normal sertoli cells arranged in nests and tubules. Histopathology of the orchidectomy specimen confirmed the diagnosis. The literature is briefly reviewed.
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3/22. Giant Sertoli cell nodule of the testis: distinction from other Sertoli cell lesions.

    The case of a 33-year-old man with a clinically suspected testicular neoplasm is reported here. The radical orchidectomy specimen showed a sharply demarcated, firm, yellow-white 1-cm nodule beneath the tunica albuginea at the upper pole. Microscopical examination showed the encapsulated nodule to be composed of tubules lined by immature sertoli cells with interspersed spermatogonia and an interwoven network of hyalinised basement membrane having foci of calcification. Immunohistochemical studies verified the fetal phenotype of the sertoli cells and the non-neoplastic nature of the germ cell component. Except for the large size, the findings were identical to those of a Sertoli cell nodule-a typically microscopic, unencapsulated lesion commonly detected in cryptorchid testes. The term "giant Sertoli cell nodule" is used for this unique, hitherto undescribed lesion and its distinction from other Sertoli cell lesions of the testis is considered here.
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4/22. Ovarian sex cord tumor with annular tubules.

    A pathologic study was done on four cases of ovarian sex cord tumor with annular tubules. All four tumors occurred in young women (11-24 years of age) and were not associated with the peutz-jeghers syndrome. Two patients had evidence of hyperestrinism. One patient who had metastasis to the retroperitoneum, left supraclavicular lymph node, and liver confirmed the malignant potential of this tumor. Gross examination revealed tumors that were solid, yellowish, and unilateral, with varying degrees of cystic degeneration. Microscopic examination showed simple or complex annular tubules with prominent basement membranes. Many tumor cells contained lipid in the cytoplasm. Ultrastructural study showed Charcot-Bottcher filaments in all four cases, indicating Sertoli cell differentiation. True lumens and microvilli were identified in one case. The classification of the sex cord tumor with annular tubules as a sertoli cell tumor, annular tubular type was proposed on the basis of ultrastructural findings.
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5/22. Incipient germ cell tumor in Sertoli-cell-only syndrome testis, accompanied with retroperitoneal teratocarcinoma and widespread metastases.

    Incipient germ cell tumor in Sertoli-cell-only syndrome testis was examined in an autopsy case of retroperitoneal teratocarcinoma with widespread metastases. Although both testes of a 28-year-old man had clinically been small and free from tumor mass to palpation, histopathological examinations revealed a malignancy in the right testis with the appearance of Sertoli-cell-only syndrome. The left testis showed solely the histology of Sertoli-cell-only syndrome. The testicular malignancy consisted of undifferentiated, atypical germ cells mainly confined within approximately one-tenth of seminiferous tubules, and only one small cartilage nodule. Some tubules showed intratubular growth pattern suggestive of seminoma. A few syncytiotrophoblast-like giant cells occurred in the tubules. These findings seem to furnish substantial evidence to the concept that atypical germ cells are the origin of testicular germ cell tumors of different types.
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6/22. Does ovarian sex cord tumour with annular tubules produce progesterone?

    Probable progesterone production was identified by an immunoperoxidase assay in a case of an ovarian sex cord tumour with annular tubules. The tumour was associated with a serous cystadenofibroma in the opposite ovary and with adenoma malignum (adenocarcinoma) of the cervix.
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7/22. A testicular tumor resembling the sex cord with annular tubules in a case of the androgen insensitivity syndrome.

    sex cord tumor with annular tubules (SCTAT) is a distinctive neoplasm with indifferent cells of sex cord derivation in a characteristic arrangement of ring-like tubules. Much attention has been drawn to its association with the peutz-jeghers syndrome (PJS) with reported occurrence of the tumor in the testis of a boy with PJS. The authors present two cases of the androgen insensitivity syndrome (AIS), one of the cases being distinctive in having a large multicystic tumor resembling the SCTAT in the immature gonad. Additionally, the focal areas of the tumor, the large sertoli cells lining the tubules, resembled those of a large cell calcifying sertoli cell tumor (LCCSCT) although no calcific areas were discernible. Although the occurrence of neoplasms like germinomas and tubular adenomas is well known in the AIS, SCTAT has hitherto not been reported in a gonad of the AIS. SCTAT has been placed under an "unclassified sex cord-stromal" category in the world health organization (WHO) classification, yet, opinions are divided as to its origin from a granulosa or Sertoli cell, although an overlap in the histologic features of the two cell categories is to be anticipated in view of their homologous nature. In the case presented, the close resemblance of the tumor cells to the sertoli cells of the uninvolved gonad would further support the concept of a Sertoli line of differentiation of the SCTAT.
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8/22. progesterone secreting sertoli cell tumor of the ovary.

    A 33-year-old woman presenting with secondary amenorrhea and galactorrhea was found to have a sertoli cell tumor of the ovary. The neoplasm also had a sex cord tumor with annular tubules (SCTAT) component. Further investigations revealed that in many respects the patient was endocrinologically pregnant. She had markedly elevated serum estrogen and progesterone levels and the endometrium demonstrated pronounced decidualization, but there was no evidence of actual pregnancy. Estrogen and progesterone were demonstrated by immunohistochemistry to be present in both the Sertoli cell and SCTAT portions of the tumor.
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9/22. Ovarian stromal tumors with minor sex cord elements: a report of seven cases.

    Seven ovarian tumors that were predominantly stromal, but contained, in addition, a minor component of sex cord elements, were encountered in patients ranging from 16 to 65 years of age. The tumors varied from 1 to 10 cm in diameter and resembled grossly fibromas or thecomas. On microscopical examination they were predominantly fibromatous, but also contained small nests or tubules composed of cells resembling granulosa cells, sertoli cells, or indifferent cells of sex cord type. Two tumors also had cells of steroid-hormone-cell type; these cells contained crystalloids of Reinke in one case. These two tumors were classified as luteinized thecoma and stromal-leydig cell tumor with minor sex cord elements. The other five tumors were designated fibromas with minor sex cord elements. Five-year follow-up, available in three cases, revealed no evidence of recurrence after operative removal. Although the presence of sex cord components has generally resulted in the classification of an ovarian tumor in either the granulosa cell or Sertoli-Leydig cell category, we propose that tumors with only minor sex cord components be placed in a separate category.
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10/22. Ovarian Sertoli-Leydig cell tumors with a retiform pattern: a problem in histopathologic diagnosis. A report of 25 cases.

    A review of 232 cases of ovarian Sertoli-Leydig cell tumors yielded 25 that contained a prominent component with a retiform pattern. A lack of awareness of this pattern, which has not been described adequately in the literature, resulted in frequent initial misinterpretation of these tumors as neoplasms of other types, including endodermal sinus tumor (seven cases) and serous adenocarcinoma (four cases). The patients ranged in age from 2 to 39 years. Three of them (12%) presented because of androgenic manifestations; most of the remainder complained of abdominal swelling or pain, but one of them was amenorrheic and hirsute and three had amenorrhea, suggesting androgen secretion by the tumor. All the tumors were Stage I; one was bilateral. Their average maximum dimension was 16 cm and they were typically cystic or both cystic and solid. In eight tumors the cysts were lined by papillae, which were edematous in five cases. On microscopic examination the retiform pattern, which predominated in 14 of the 25 tumors, was characterized by an irregular network of elongated, often slit-like tubules and cysts, which often contained papillae and resembled the rete testis. Follow-up of 21 patients from 6 months to 17 years (average 4 years) revealed that 16 of them were alive and free of disease; five had died of tumor from 6 months to 17 years postoperatively.
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