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Asian J Surg 2021 Apr 21. Epub 2021 Apr 21.

Department of Pediatric Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address:

Testis-sparing surgery (TSS) has been increasingly used for treating a variety of testicular tumors (TTs) in children. However, the indications and feasibility associated with TSS remain uncertain. This study aimed to present the clinical outcomes of TSS in children with TTs. Read More

Adv Anat Pathol 2021 Apr 12. Epub 2021 Apr 12.

Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.

Testicular tumors are incredibly diverse and one of the most challenging areas in surgical pathology. Because of the rarity and overlapping features with numerous entities occurring in the testis and paratestis, these tumors pose a diagnostic challenge even to the most experienced general pathologists. In 2016, the latest "World Health Organization (WHO) classification of testicular tumors" was released, which incorporated several updates to the previous 2004 classification system. Read More

Pediatr Blood Cancer 2021 Mar 24:e29017. Epub 2021 Mar 24.

Gustave Roussy, Department of Pediatric Oncology, Université Paris-Saclay, Villejuif, France.

As part of the European Union-funded project designated Paediatric Rare Tumours Network - European Registry (PARTNER), the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) is continuously developing consensus recommendations in order to harmonize standard care for very rare solid tumors of children and adolescents. This paper presents the internationally recognized recommendations for the diagnosis and treatment of sex cord stromal tumors (SCST). The clinical approach to sex cord stromal tumors of the testis (TSCST) and ovary (OSCST) depends on histological differentiation and tumor stage. Read More

Transl Androl Urol 2020 Dec;9(6):2836-2841

Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China.

Testicular sex cord-stromal tumors are less common in men, while mixed sex cord-stromal tumors (MSCSTs) are rarer. Recently, we found a MSCST in an adult male testis [adult granulosa cell tumor (AGCT) with Sertoli cell tumor]. He was admitted to the hospital based on "left testicular bloating and dull pain for 20 years and aggravating for 10 days". Read More

Int J Mol Sci 2020 Dec 29;22(1). Epub 2020 Dec 29.

The Research Institute of the McGill University Health Centre, Montreal, QC H4A 3J1, Canada.

The mitochondrial translocator protein (TSPO) has been shown to bind cholesterol with high affinity and is involved in mediating its availability for steroidogenesis. We recently reported that targeted gene deletion in MA-10 mouse tumor Leydig cells resulted in reduced cAMP-stimulated steroid formation and significant reduction in the mitochondrial membrane potential (ΔΨ) compared to control cells. We hypothesized that ΔΨ reduction in the absence of TSPO probably reflects the dysregulation and/or maintenance failure of some basic mitochondrial function(s). Read More

Pathology 2021 Feb 25;53(2):166-169. Epub 2020 Dec 25.

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.

Mixed germ cell-sex cord stromal tumours (MGC-SCSTs) of the testis and ovary differ significantly in their histological appearance, clinical behaviour, and molecular genetics. Until recently, the germ cells of testicular MGC-SCST were considered to be invariably histologically bland, whereas those from neoplasms that arise in the ovary have histological features characteristic of premalignancy. However, a recent histological and molecular genetic study demonstrated histological abnormalities and multiple chromosomal losses and gains in a small subset of testicular cases, thus providing the first evidence that testicular MGC-SCSTs can exceptionally show histological and molecular abnormalities. Read More

Urologe A 2021 Feb;60(2):222-225

Klinik für Kinderurologie in Kooperation mit der Universität Regensburg, Krankenhaus Barmherzige Brüder, Klinik St. Hedwig, Steinmetzstraße 1-3, 93049, Regensburg, Deutschland.

Juvenile granulosa cell tumor of the testis is a relevant differential diagnosis regarding testicular neoplasia of the very young. This benign lesion requires surgical treatment. Metastases or recurrences have not been described in literature. Read More

Urol Case Rep 2020 Nov 30;33:101368. Epub 2020 Jul 30.

King Abdullah International Medical Research Center (KAIMRC), Riyadh, 11426, Saudi Arabia.

Sex cord Stromal are neoplasms containing granulosa, Sertoli, and Leydig cells. The problem usually occurs among females that are hormonally active and is associated to Gorlin-Goltz syndrome. The present study reports a 37-year-old male was referred to Urologist due to a firm right testicular mass for which orchiectomy was performed. Read More

Cesk Patol 2020 ;56(3):153-160

The great majority of testicular tumors can be diagnosed on the basis of morphology, while immunohistochemistry and molecular genetics assist in only a small proportion of cases. Similar to other areas of pathology, ancillary diagnostic methods have to be used responsibly and assessed in correlation with morphological, serological and clinical findings. Prior to their effective use, a limited differential diagnosis based on morphology is required. Read More

Cancers (Basel) 2020 Oct 6;12(10). Epub 2020 Oct 6.

Princess Máxima Center for Pediatric Oncology, 3584 Utrecht, The Netherlands.

Objective: The purpose of this review is to evaluate the outcomes of testis sparing surgery (TSS) and to investigate under which circumstances TSS can be considered a safe treatment option in pediatric patients with testicular tumors.

Methods: A database search was performed in Cochrane, Pubmed, and Embase for studies that focused on TSS as treatment for testicular tumors in the pediatric population, excluding reviews and single case reports.

Results: Twenty studies, describing the surgical treatment of 777 patients with testicular tumors, were included in the analysis. Read More

Pathol Res Pract 2020 Nov 5;216(11):153198. Epub 2020 Sep 5.

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Van Nuys Medical Science Building 128, 635 Barnhill Drive, Indianapolis, IN 46240-5120, United States; Department of Urology, Indiana University School of Medicine, Indianapolis, IN 46240-5120, United States.

Gonadoblastoma occurring in a normal girl or woman has been confused with ovarian mixed germ cell-sex cord stromal tumor (MGC-SCST) due to a lack of knowledge that the former occurs occasionally in a normal woman or girl. In this article, we develop histological criteria that facilitate the distinction of gonadoblastoma in an individual with a normal karyotype and no evidence of a disorder of sex development from ovarian MGC-SCST. We reviewed the histological findings of gonadoblastoma occurring in normal individuals and compared them to cases of ovarian MGC-SCST in our files. Read More

Medicine (Baltimore) 2020 Sep;99(36):e22085

Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, Jilin 130021, PR China.

Rationale: Testicular tumors represent 1% to 1.5% of all tumors in men. Those derived from Leydig cells are rare and account for 1% of testicular tumors. Read More

Int Urol Nephrol 2021 Feb 7;53(2):257-267. Epub 2020 Sep 7.

Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, CA, 94305, USA.

Purpose: To describe clinical characteristics and identify prognostic factors among men with testicular sarcoma, and to compare survival with other testicular cancers.

Methods: The surveillance, epidemiology, and end results (SEER) database (1975-2016) was queried to identify adults with testicular sarcoma. Multivariable Cox proportional hazards, Fine and Gray competing-risks regression, propensity score matching, and Kaplan-Meier analyses were used. Read More

Indian J Pathol Microbiol 2020 Jul-Sep;63(3):470-471

Department of Pathology, RNT Medical College, Udaipur, Rajasthan, India.

We report a case of testicular granulosa cell tumor of adult type in a 65-year-old male patient who has presented with hepatic metastasis. Although, this type of sex cord stromal tumor is relatively common in the ovaries, it is extremely unusual in the testis, and it probably represents the rarest type of testicular sex cord stromal tumor. Read More

J Cancer Res Clin Oncol 2020 Nov 27;146(11):2829-2841. Epub 2020 Jul 27.

Department of Urology, University Hospital, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.

Purpose: Testicular granulosa cell tumors (tGrCT) are rare sex cord-stromal tumors. This review aims to synthesize the available evidence regarding the clinical presentation and clinicopathological characteristics, treatment and outcomes.

Methods: We conducted a systematic literature search using the most important research databases. Read More

Am J Surg Pathol 2020 08;44(8):1082-1091

Indiana University School of Medicine, Indianapolis, IN.

Some recent reports suggested that many Sertoli cell tumors, not otherwise specified (SCTs-NOS) of the testis were analogs of the solid pseudopapillary neoplasm (SPN) of the pancreas. One of the most relied on pieces of information for this assertion was the shared occurrence in both neoplasms of exon 3 mutations of the CTNNB1 gene, which was reflected by nuclear β-catenin expression. We, therefore, compared the morphologic and immunohistochemical features of 18 SCTs-NOS with strong, diffuse nuclear β-catenin expression with 16 SPNs that also showed such positivity. Read More

Int J Mol Sci 2020 May 21;21(10). Epub 2020 May 21.

Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland.

Although epidemiological studies from the last years report an increase in the incidences of Leydig cell tumors (previously thought to be a rare disease), the biochemical characteristics of that tumor important for understanding its etiology, diagnosis, and therapy still remains not completely characterized. Our prior studies reported G-protein coupled estrogen receptor signaling and estrogen level disturbances in Leydig cell tumors. In addition, we found that expressions of multi-level-acting lipid balance- and steroidogenesis-controlling proteins including peroxisome proliferator-activated receptor are altered in this tumor. Read More

Virchows Arch 2020 Nov 23;477(5):615-623. Epub 2020 May 23.

Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.

The existence of a true mixed germ cell-sex cord stromal tumor (MGSCT) of the testis remains controversial. Based on our experience with rare testicular tumors in this spectrum, we sought to perform a detailed clinicopathologic and molecular study of MGCSCT. Eight cases of testicular MGSCT were morphologically reviewed, screened for chromosomal aberrations (using array comparative genomic hybridization (aCGH) and low pass genomic sequencing), and analyzed by next generation sequencing (The Illumina TruSight Tumor 170). Read More

Arch Ital Urol Androl 2020 Apr 7;92(1):61-63. Epub 2020 Apr 7.

Department of Urology, Aristotle University of Thessaloniki, "G. Gennimatas" General Hospital, Thessaloniki.

Hydrocele is the most common benign cause of painless scrotal enlargement and only very rarely can be reactive to an underlying testicular tumor. We present the case of a healthy young man, complaining of mild left scrotal discomfort and swelling. Physical examination revealed a non-tender fluctuant left scrotum and serum tumor markers were normal. Read More

Zhonghua Nan Ke Xue 2019 Apr;25(5):346-350

Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.

Objective: To explore the color Doppler ultrasonic characteristics of testicular Leydig cell tumors (LCT) and improve the clinical diagnosis of the disease.

Methods: We retrospectively analyzed 4 cases of testicular LCT diagnosed and treated in our hospital and summarized the experience in the ultrasonic diagnosis of LCT with a review of the relevant literature.

Results: All the 4 testicular LCTs were solitary and quasi-round, 1 in the left and 3 in the right. Read More

Protoplasma 2020 Jul 16;257(4):1149-1163. Epub 2020 Mar 16.

Department of Endocrinology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University in Kraków, Poland, Gronostajowa 9, 30-387, Kraków, Poland.

Leydig cell tumors (LCT) are the most common type of testicular stromal tumor. Herein, we investigate the G protein-coupled estrogen receptor (GPER) and peroxisome proliferator-activated receptor (PPAR) implication in regulation of lipid homeostasis including the expression of steroidogenesis-controlling molecules in clinical specimens of LCTs and tumor Leydig cells (MA-10). We showed the general structure and morphology of LCTs by scanning electron and light microscopy. Read More

Transl Androl Urol 2020 Jan;9(Suppl 1):S91-S103

Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.

Testicular cancer is the most common solid malignancy in male adolescents and young adults, with germ cell derived seminomas and non-seminomas being by far the most common histologies. Teratoma with somatic-type malignancy is a rare chemo-resistant phenotype of testis cancer associated with poor prognosis in patients with advanced stage disease. Malignant gonadal-stromal tumors comprise 5% of testicular neoplasms and approximately 10% are malignant and considered chemo-radiation resistant. Read More

Oncologist 2020 07 11;25(7):585-590. Epub 2020 Feb 11.

Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland.

Background: Sertoli cell tumors (SCTs) of the testes are rare, and the literature provides only weak evidence concerning their clinical course and management. The objective of this study was to summarize evidence on SCTs' clinical presentation, clinicopathological risk factors for malignancy, treatment options, and oncological outcomes.

Materials And Methods: Data sources included Medline, Embase, Scopus, the Cochrane Database of Systematic Reviews, and Web of Science. Read More

Pathologica 2019 Dec;111(4):375-381

Department of Oncology and Hemato-oncology, University of Milan, and SSD Clinical Psychology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

In 1865, Enrico Sertoli, at the age of 23, published an article in his own name entitled: "About the existence of special branched cells in the seminiferous tubules of the human testis". These were Sertoli's ideal cells; in this paper he arrived at a perspicacious description of the morphology and function of these cells and in the subsequent articles he investigated the topic of spermatogenesis. Despite the importance of Sertoli's discovery, the attention of the scientific literature remained very limited after Sertoli's death for half a century and the partial eclipse finished only in the 1970s of the twentieth century. Read More

Curr Opin Urol 2020 03;30(2):235-244

Department of Urology.

Purpose Of Review: The presence of vascular solid tumors within the testicle is considered to be malignant until proven otherwise. However, it is prudent for clinicians to be aware of rare benign and malignant intratesticular lesions as management can differ from the established treatment algorithms for germ-cell tumors.

Recent Findings: Utilizing certain histopathologic findings can assist with the diagnosis of rare testis tumors. Read More

J Urol 2020 05 17;203(5):949-956. Epub 2019 Dec 17.

Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Purpose: Leydig cell tumors are rare but they are the most common nongerm cell testicular tumors. Only limited evidence exists for reliably differentiating between benign and malignant Leydig cell tumors and for optimally managing the different types and stages of this rare disease. In this review we synthesize the available evidence on the clinical presentation and clinicopathological characteristics associated with Leydig cell tumor malignancy and management. Read More

Int Urol Nephrol 2020 Apr 11;52(4):693-695. Epub 2019 Dec 11.

Centro de Pesquisa E Assistência Em Reprodução Humana (CEPARH), Rua Caetano Moura, 35 Federação, Salvador, BA, 40210-341, Brazil.

Int Braz J Urol 2019 Nov-Dec;45(6):1260-1265

Departamento de Urologia da Santa Casa de Misericórdia de Ribeirão Preto, São Paulo, Brasil.

Testicle tumors are a rare entity among men population, accounting for only 1-1.5% of all can-cers among men. The stromal tumors of the sexual cord correspond just 4% of all testicular cancers. Read More

Tissue Cell 2019 Dec 7;61:51-60. Epub 2019 Aug 7.

Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Kraków, Gronostajowa 9, 30-387 Krakow, Poland.

The etiology and molecular characteristics of Leydig cell tumor (LCT) are scarcely known. From the research data stems that estrogen can be implicated in LCT induction and development, however it is not investigated in detail. Considering the above, herein we analyzed the relation between G-protein coupled membrane estrogen receptor, peroxisome proliferator-activated receptor and insulin-like family peptides (insulin-like 3 peptide; INSL3 and relaxin; RLN) expressions as well as estrogen level with impact of xenoestrogen (bisphenol A; BPA, tetrabromobisphenol A; TBBPA, and tetrachlorobisphenol A; TCBPA). Read More

Urology 2019 Dec 24;134:203-208. Epub 2019 Sep 24.

Division of Urology, Department of Surgery, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. Electronic address:

Objective: To review our single institution experience, exploring the role of testis-sparing surgical resection in a cohort of children with Testicular Leydig cell tumors (LCTs).

Materials And Methods: We reviewed all consecutive children presenting with testicular tumors between 2003 and 2017 (n = 66), excluding patients with alternative pathologies (n = 57). Subsequently data were collected on age at surgery, laterality, type of surgery, operative time, presenting symptoms, serum markers, imaging findings, frozen section, final pathology, and follow-up. Read More