Testicular sex cord stromal tumors
- Mary-Ellen Taplin, MD
Mary-Ellen Taplin, MD
- Professor of Medicine
- Harvard Medical School
Sex cord stromal tumors (SCSTs) comprise approximately 5 percent of all testicular tumors, while the remainder are of germ cell origin . SCSTs, which arise from the supporting tissues of the testis, include Leydig, Sertoli, and granulosa cell tumors, as well as malignant mesothelioma of the tunica vaginalis, adenocarcinoma of the rete testis, and paratesticular rhabdomyosarcoma (table 1) [2-5]. In 2017, the World Health Organization (WHO) published a review and update of the classification of testicular non-germ cell tumors .
The clinical presentation and management of SCSTs are discussed here. The pathology of SCSTs and an overview of testicular germ cell tumors are presented separately. (See "Anatomy and pathology of testicular tumors", section on 'Sex cord-stromal tumors' and "Overview of the treatment of testicular germ cell tumors".)
The most common clinical presentation of testicular SCSTs is with a mass, which often causes swelling and/or discomfort. Tumors may also be discovered on routine physical examination or during evaluation for endocrine symptoms due to sex hormone production [2,7]. In general, there is a wide age range for SCSTs, with ages in two contemporary series ranging between 14 and 87 years [8,9].
There are no known risk factors for SCSTs. Unlike germ cell tumors, there has been no definitive association with cryptorchidism, although such an association cannot be excluded [10,11].
SCSTs do not typically produce markers such as lactate dehydrogenase (LDH), alpha-fetoprotein (AFP), and human chorionic gonadotropin (hCG), which are more commonly elevated in testicular germ cell tumors.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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