British Journal of Urology (1979), 51.412
Sertoli Cell Tumour of the Testis This tumour is thought to be derived from the testicular stroma and has also been called a gonadal stromal tumour and an androblastoma. It is rare and occurs in 1.2% of tumours referred to the Testicular Tumour Panel between 1958 and 1973 (Pugh, 1976).
Case Report A 24-year-old presented with a painless swelling of the left testis of 2 years’ duration. The testis measured 8 x 4.5 x 3.2 cm; the right testis was normal. He had no other signs or symptoms and his general investigations were negative. The left testis was explored and a frozen section suggested a “non-malignant growth”. The testis was removed. The tumour measured 4.5 x 3.5 x 3.2 cm and had the microscopic appearance of a Sertoli cell tumour of the strdmal type without evidence of malignancy (Fig.). The patient was discharged from hospital on the seventh post-operative day. Hormonal measurement after orchiectomy showed an increased output of 17 oxysteroids (25.7 units). Urinary gonadotrophins were not measured. Comment The first case of Sertoli cell tumour was recorded in 1944 (Teilum, 1958) but there are now more than 70 reports in the literature (Kalis and Goulandris, 1974). The patient usually complains of a small, hard, rapidly growing swelling of the testis which may be associated with an undescended testis, or with other tumours. Approximately one-third present with some degree of gynaecomastia which resolves after orchiectomy. The tumour in this case was characteristically discrete from the testis and off-white in colour. Microscopically there are 3 types, depending upon the proportion of epithelial and stromal tissue. The stromal type is the most undifferentiated; the epithelial or tubular type is more differentiated and associated with the production of female hormones; the third type is a mixture of both cell types. Until 1966 there had been no report of a malig-
Fig. Photomicrograph of tumour (Hand E ~ 4 5 0 ) .
nant Sertoli cell tumour but 14 cases progressing to malignancy have now been reported (Pugh, 1976); the incidence of malignancy is probably between 10 and 20% and all cases require regular follow-up.
References
412
Kalis, E. G. and Goulandris, N. D. (1974). AndroblastomaSertoli cell tumour. Journal of Uro/ogy, 112,618-619. Pugh, R. C. B. (1976). Puthology oJ the Testis. Oxford: Blac kwell. Teilum, G. (1958). Classification of testicular and ovarian androblastoma and Sertoli-cell tumours. Cuncer, 11, 769-782.
The Authors S. M. Mantoudis, N. S. Apostolidis, N. C. Legakis and M. C. Philippakis, Department of Surgery, Athens University Medical School, Hippokrateion Hospital, Athens 610, Greece. Requests for reprints to: S. M. Mantoudis, 5 Herekleitou Street, Athens 136, Greece.
Sertoli Cell Tumour of the Testis This tumour is thought to be derived from the testicular stroma and has also been called a gonadal stromal tumour and an androblastoma. It is rare and occurs in 1.2% of tumours referred to the Testicular Tumour Panel between 1958 and 1973 (Pugh, 1976).
Case Report A 24-year-old presented with a painless swelling of the left testis of 2 years’ duration. The testis measured 8 x 4.5 x 3.2 cm; the right testis was normal. He had no other signs or symptoms and his general investigations were negative. The left testis was explored and a frozen section suggested a “non-malignant growth”. The testis was removed. The tumour measured 4.5 x 3.5 x 3.2 cm and had the microscopic appearance of a Sertoli cell tumour of the strdmal type without evidence of malignancy (Fig.). The patient was discharged from hospital on the seventh post-operative day. Hormonal measurement after orchiectomy showed an increased output of 17 oxysteroids (25.7 units). Urinary gonadotrophins were not measured. Comment The first case of Sertoli cell tumour was recorded in 1944 (Teilum, 1958) but there are now more than 70 reports in the literature (Kalis and Goulandris, 1974). The patient usually complains of a small, hard, rapidly growing swelling of the testis which may be associated with an undescended testis, or with other tumours. Approximately one-third present with some degree of gynaecomastia which resolves after orchiectomy. The tumour in this case was characteristically discrete from the testis and off-white in colour. Microscopically there are 3 types, depending upon the proportion of epithelial and stromal tissue. The stromal type is the most undifferentiated; the epithelial or tubular type is more differentiated and associated with the production of female hormones; the third type is a mixture of both cell types. Until 1966 there had been no report of a malig-
Fig. Photomicrograph of tumour (Hand E ~ 4 5 0 ) .
nant Sertoli cell tumour but 14 cases progressing to malignancy have now been reported (Pugh, 1976); the incidence of malignancy is probably between 10 and 20% and all cases require regular follow-up.
References
412
Kalis, E. G. and Goulandris, N. D. (1974). AndroblastomaSertoli cell tumour. Journal of Uro/ogy, 112,618-619. Pugh, R. C. B. (1976). Puthology oJ the Testis. Oxford: Blac kwell. Teilum, G. (1958). Classification of testicular and ovarian androblastoma and Sertoli-cell tumours. Cuncer, 11, 769-782.
The Authors S. M. Mantoudis, N. S. Apostolidis, N. C. Legakis and M. C. Philippakis, Department of Surgery, Athens University Medical School, Hippokrateion Hospital, Athens 610, Greece. Requests for reprints to: S. M. Mantoudis, 5 Herekleitou Street, Athens 136, Greece.
