GPR: 2019 - Week 33

From MGH Learn Pathology

Clinical history

50-year-old male with an ultrasound showing a heterogenous intratesticular mass suspicious for malignancy.


GPR19-20 -Leydig Cell Tumor.JPG


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GPR19-20 -Leydig Cell Tumor.JPG

 
Leydig Cell Tumor
  • Pure testicular stromal tumor; majority are benign
  • Well-circumscribed, homogeneous intraparenchymal mass usually confined to testis
  • Golden-brown to yellow, or gray-white (this case: lipid-rich)
  • Lobulation may be seen
  • Focal hemorrhage or necrosis in ~25% of cases
 

GPR19-20 -Met RCC to Testis edited.JPG

 

Metastatic renal cell carcinoma, clear cell type

  • In general, metastatic disease to the testes is uncommon
  • May be solitary, multiple, or diffuse enlargement of testis with no obvious mass
  • Majority are unilateral & solitary
  • Metastatic RCC is extremely rare (~30 reported cases; almost all are clear cell)
  • This case: well-circumscribed yellow & hemorrhagic mass confined to the testis
 

GPR19-20 -seminoma for GPR s19-39432 edited.JPG

 

Seminoma

  • Well circumscribed +/- lobulations
  • Homogeneous
  • Gray-white, tan, creamy, fleshy or firm
  • Often bulging cut surface
  • Majority are confined to testis
  • Usually no hemorrhage or necrosis (if present, concern for nonseminomatous components)
 

GPR19-20 -sertoli cell tumor for GPR.JPG

 

Sertoli Cell Tumor

  • Pure sex cord-stromal tumor composed of Sertoli cells
  • Usually small; size range 2-5 cm
  • Well-circumscribed, homogeneous, firm
  • Gray-white to yellow (note: Leydig Cell Tumors are usually more brown/yellow due to high lipid content)
  • May be lobulated with focal cystic changes or hemorrhage
 
Dr. Megan Fitzpatrick
  • ExpertPath
  • Marzouk K, Alyami F, Merrimen J, Bagnell S. Metastatic renal cell carcinoma to the testis: A case report and review of the literature. Can Urol Assoc J. 2014;8(11-12):E924–E927. doi:10.5489/cuaj.2209

This week's Gross Pathology Roundup was presented by Diane Brackett, MD on Mon, Aug 12, 2019.