American Urological Association - Sertoli Cell Tumor (SCT)
Sertoli Cell Tumor (SCT)
- 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).
- 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.
- 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-.