Variant of SCT characterized by peculiar calcifications admixed with large epithelioid cells.
Usually younger patients, age 1.5-48 years old (ave. 16 years).
Slowly growing painless testicular mass.
Higher frequency of bilaterality (40%) and multifocality (60%) among SCTs.
Most occur as sporadic tumors (60%) or in patients with Carney syndrome and Peutz-Jeghers syndrome.
Carney syndrome includes cardiac or cutaneous myxomas, lentigines, mucocutaneous blue nevi, and endocrine overactivity and tumors.
Peutz-Jeghers syndrome includes hamartomatous intestinal polyps and mucocutaenous macular hyperpigmentation.
Patients may have gynecomastia or precocious puberty.
Hallmark: wavy or irregular laminated nodular calcifications or small psammoma bodies (image A) & (image B).
Large polygonal cells with abundant pink, "ground-glass" or finely granular cytoplasm.
Growth patterns: nests, cords, trabecular, or solid tubules.
Majority has good prognosis; 20% malignant.