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Gonadoblastoma
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- Composed of a mixture of seminoma-like cells (germ cell components) and Sertoli-like cells (sex-cord component)
- Clinical features: usually arise in abnormal dysgenetic gonads of patients with intersex syndromes (20% are phenotypic male; 80% are phenotypic female -- but nearly all patients have Y chromosome); 30% bilateral
- Gross: solid yellow-tan nodules with gritty calcifications
- Histologic features:
- well rounded nests of large pale seminoma-like cells with abundant clear cytoplasm and well-defined cytoplasmic membranes
- admixed are dark angular sex-cord cells that look like Sertoli cells that tend to palisade at the periphery of the tumor nests
- the basement membranes can become very hyalinized and even calcified
- 2/3 of cases demonstrate nodular aggregates of Leydig cells as well.
- Treatment and prognosis: gonadoblastomas represent pre-malignant lesions from which malignant germ cell tumors can arise; therefore, since the majority of patients have gonadal dysgenesis and therefore run a high risk of bilateral tumors, the recommended treatment is bilateral orchiectomy
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