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Case of the Month



Testicular Granulosa Cell Tumor

A 64 year-old male presents with a 9 month history of a firm, non-tender left testicular mass. He underwent a radical orchiectomy. Grossly, the 4.5 cm tumor is fairly well-circumscribed and is involving the rete testis.

Sections show mildly pleomorphic elongated-to-spindled nuclei with occasional grooves and mostly inconspicuous nucleoli. Tumor cells are present in sheets and in trabecular and insular patterns and are within a fibrous stroma.

Numerous Call-Exner bodies (follicle-like structures with acidophilic material) are present. Mitoses are not prominent.

The tumor cells stain positive with the inhibin, vimentin, S-100, and CD99 immunohistochemical stains. Pertinent negative staining includes SALL4, CD-117, OCT4, and CD-30.

The histologic features and immunohistochemical staining pattern is consistent with granulosa cell tumor of the testis.

Adult testicular granulosa cell tumor is a very rare sex cord-stromal tumor with a potential to metastasize to distal sites years after initial diagnosis.