+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Sex cord stromal testicular tumors: a clinical series--uniformly stage I disease



Sex cord stromal testicular tumors: a clinical series--uniformly stage I disease



Journal of Urology 181(5): 2090-6; Discussion 2096



Sex cord stromal testicular tumors are rare. Historically 10% of lesions are said to be malignant but to our knowledge there are no clinical or histological features that can accurately predict potential malignant behavior. Because of this, groups at some centers have advocated prophylactic retroperitoneal lymph node dissection in patients with clinical stage I disease. We reviewed our experience with these tumors to determine whether this policy is justified. We retrospectively reviewed the records of all 38 men older than 18 years with sex cord stromal testicular tumors who were referred to the Wessex regional cancer center for treatment or pathological review during the 25-year period of 1982 to 2006. We then compared our series with a malignant sex cord stromal testicular tumor database generated from the world literature. All Wessex patients were treated with excision of the primary tumor alone and metastatic disease developed in none. All remained disease-free with an overall median survival of 6.8 years (range 1.4 to 25). Features in the literature favoring malignant behavior, ie metastatic disease, included larger tumors (mean 6.43 vs 1.71 cm), a high mitotic rate, tumor necrosis, angiolymphatic invasion, infiltrative margins and extratesticular extension (each p <0.0001). The malignant group had an overall median survival of 2.3 years (range 0.02 to 17.3). No patient had disease progression in our study, which is to our knowledge the largest reported United Kingdom series of sex cord stromal testicular tumors. Our data suggest that malignancy is uncommon and prophylactic retroperitoneal lymph node dissection is unjustified for clinical stage I disease.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055743078

Download citation: RISBibTeXText

PMID: 19286222

DOI: 10.1016/j.juro.2009.01.038


Related references

Pathologic Risk Factors for Metastatic Disease in Postpubertal Patients With Clinical Stage I Testicular Stromal Tumors. Urology 97: 138-144, 2016

Clinical outcome in testicular sex cord stromal tumors: testis sparing vs. radical orchiectomy and management of advanced disease. Urology 85(2): 402-406, 2015

Sertoli cell proliferations An intratubular stage in the evolution of testicular sex cord and stromal tumors?. International Journal of Andrology 20(SUPPL 1): 47, 1997

Perspectives on testicular sex cord-stromal tumors and those composed of both germ cells and sex cord-stromal derivatives with a comparison to corresponding ovarian neoplasms. Human Pathology 65: 1-14, 2017

Clinical outcomes of local and metastatic testicular sex cord-stromal tumors. Journal of Urology 192(2): 415-419, 2014

Pathologic Risk Factors in Pediatric and Adolescent Patients With Clinical Stage I Testicular Stromal Tumors. Journal of Pediatric Hematology/Oncology 37(8): E441-E446, 2016

Oncologic Outcomes Following Surgical Management of Clinical Stage II Sex Cord Stromal Tumors. Urology 2019, 2019

Does RPLND have a curative role for sex cord-stromal testicular tumors?. Journal of Urology 167(4 Supplement): 155, 2002

Müllerian inhibiting substance, alpha-inhibin, and CD99 expression in sex cord-stromal tumors and endometrioid ovarian carcinomas resembling sex cord-stromal tumors. Human Pathology. 29(8): 840-845,., 1998

Current treatment of testicular sex cord-stromal tumors: critical review. Urology 73(6): 1165-1171, 2009

Testicular sex cord stromal tumors: analysis of patients from the MAKEI study. Pediatric Blood and Cancer 60(10): 1651-1655, 2013

Inhibin A is a sensitive and specific marker for testicular sex cord-stromal tumors. Modern Pathology 11(8): 774-779, 1998

Classification and pathology of testicular germ cell and sex cord-stromal tumors. Urologic Clinics of North America 26(3): 595-609, 1999

Management of ovarian and testicular sex cord-stromal tumors in children and adolescents. Journal of Pediatric Hematology/Oncology 34 Suppl 2: S55-S63, 2012

Recent advances in the diagnosis and classification of testicular sex cord-stromal tumors. Zhonghua Bing Li Xue Za Zhi 47(2): 139-142, 2018