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Pathology for Urologists

Sertoli Cell Tumor (SCT)


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  • Rare, comprises <1% of testicular tumors.
  • May involve any age (ave. 45 years).
  • Presents as painless slowly enlarging testicular mass.
  • May elaborate androgen or estrogen but of low quantity to cause precocious musculinization or feminization.
  • May be seen in patients with Peutz-Jeghers syndrome, Carney syndrome, androgen insensitivity syndrome, and testicular feminization syndrome.
  • Gross: Usually well-circumscribed, homogenous, solid firm gray-white mass (image A).

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  • Histology:
    • Uniform cuboidal or columnar cells with moderate pale to lightly pink cytoplasm, often with prominent cytoplasmic lipid vacuoles (image B), (image C), & (image D)).
    • Bland round to ovoid nuclei, occasional centrally located nucleoli, rare mitosis.
    • Growth patters: tubules (most common) and may resemble rete testis.
    • Other patterns include microcystic, cords, nests, solid sheets, and rarely spindled.
    • Hypocellular or hyalinized stroma.
    • May have abundant sclerosis (sclerosing SCT).
  • Charcot-Böttcher filaments (perinuclear arrays of filaments) pathognomonic electron microscopic feature.
  • Immunohistochemistry: Majority keratin+.
  • Mostly tumors have benign behavior; 10% are malignant.
  • DDX:
    • Leydig cell tumor: cells have abundant pink cytoplasm and keratin-.
    • Seminoma with tubular pattern: has clear cells, fibrous septa and lymphocytic infiltrates; Oct3/4+ and inhibin-.

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