mart-1-antigen and Calcinosis

A 19-year-old male Caucasian, without prior medical history, noticed a painless right testicular mass. Physical examination revealed neither gynecomastia nor abnormal skin pigmentation. Serum alpha-fetoprotein, β-HCG and testosterone levels were normal. Sonography depicted an intratesticular diffusely hyperechoic lesion with acoustic shadowing. The patient underwent right orchiectomy. Histology revealed a benign large cell calcifying Sertoli cell tumour. This tumour is rare and may be associated with genetic abnormalities.

Topics: Adenoma; Biomarkers, Tumor; Calbindin 2; Calcinosis; Diagnosis, Differential; Humans; Male; MART-1 Antigen; Orchiectomy; Sertoli Cell Tumor; Testicular Neoplasms; Ultrasonography; Vimentin; Young Adult

Large cell calcifying Sertoli cell tumor is a rare type of testicular tumor. Reported herein is a Japanese patient with this tumor not associated with Carney's complex. An 11-year-old boy was admitted to hospital because of left testicular enlargement, and radical orchiectomy was performed. Macroscopically, the tumor was well circumscribed and had a maximum diameter of approximately 2 cm. The cut surface showed a yellow-white solid mass. Histologically, the tumor was composed of large neoplastic cells with abundant eosinophilic cytoplasm with a tubular, trabecular, and solid arrangement and loose myxoid stroma with irregularly shaped calcification. Immunohistochemically, the tumor cells were positive for vimentin, S-100 protein, calretinin, inhibin-alpha, melan-A, and CD10, and type IV collagen and laminin were observed in the extracellular matrix around the tumor cells. The distributions of melan-A, CD10, and mitochondria were characteristically patchy; in contrast, they were diffusely distributed in the cytoplasm in a control case of Leydig cell tumor. The differences in immunostaining patterns for melan-A, CD10, and mitochondria as well as positivity for S-100 protein-beta might be useful diagnostic hallmarks of large cell calcifying Sertoli cell tumor for discrimination from Leydig cell tumor.

Topics: Antigens, Neoplasm; Calbindin 2; Calcinosis; Child; Collagen Type V; Diagnosis, Differential; Humans; Immunohistochemistry; Inhibins; Male; MART-1 Antigen; Microscopy, Electron; Neoplasm Proteins; Neprilysin; S100 Calcium Binding Protein G; S100 Proteins; Sertoli Cell Tumor; Testicular Neoplasms; Testis; Vimentin