睪丸史托利細胞惡性腫瘤:罕見病例報告

樊樂威、李威昌、劉忠一、張英勛

新北市立土城醫院

Malignant Sertoli Cell Tumor of Testis: A Rare Case Report

Le-Wei Fan, Wei-Chang Li, Chung-Yi Liu, Ying-Hsu Chang

Department of Urology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University

Abstract

Testicular Sertoli cell tumors are extremely rare, of these with malignant features are even rare. Most of Sertoli cell tumor have a benign clinical course, but 10 to 22% of these tumors can change their behavior to aggressive. The pathological judgement and final diagnosis are sometimes challenge owing to their rarity.

In this article, we present a case report of a Sertoli cell tumor, which was accidentally discovered during a urological consultation of a 52-year-old male. An ultrasound showed a 2.9 × 1.5 cm heteroechogenic, hypervascular tumor almost occupying the whole right testicle. Serum tumor markers including α-fetoprotein and β-human chorionic gonadotropin were within the normal range but lactic dehydrogenase was a little bit higher. There was no pelvic or para-aortic or cavo-aortic lymph node or visceral metastasis found in the chest and abdominal computed tomography studies. The patient underwent radical inguinal orchiectomy because of highly suspicious of malignancy. The final pathology showed histologic and immunohistochemical features were consistent with malignant Sertoli cell tumor according to the invasion of rete testis. Understanding the types of Sertoli cell tumors helps pathologists and urologists to choose the correct therapeutic approach.