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Sertoli cell tumors of ovary: light microscopic and ultrastructural study with histogenetic considerations.

Two cases of pure Sertoli cell tumors of the ovary are presented. The tumors were grey to brown and generally solid, but with several cystic areas. They showed a highly differentiated, but variable, histologic patterns with solid cords of neoplastic cells, as well as tubular formations. Ultrastructurally, the basal part of the cells rested on a nonfibrillary basement membrane layer while the free border showed occasional cilia. Laterally, the cells showed tight junctions and desmosomes. Abundant rough endoplasmic reticulum and some cystically dilated smooth endoplasmic reticulum were evident. The theories regarding the histogenesis are discussed. Enough similarities, both by light and by electron microscopy, are presented between these tumors and the Sertoli cell to justify classifying these ovarian tumors as Sertoli cell in type. The development of cilia is considered to be a manifestation of focal metaplasia of the neoplastic Sertoli cell.

Cell Nucleus

Sertoli cell tumor (gonadal stromal tumor) in an infant.

An 8-mo-old boy had an orchiectomy for a Sertoli cell tumor. Malignancy was suspected histologically. He underwent a retroperitoneal lymphadenectomy and no nodes contained metastases. The histologic criteria for malignancy in Sertoli cell tumors are controversial. Individual case reports of patients with these tumors are encouraged to help establish their natural history and optimum management.

Adult

Sertoli cell tumor of testis.

A case is reported of a patient with Sertoli cell tumor of the testis, the second known to have had a lymphangiogram and the third with histopathologic examination of retroperitoneal lymph nodes. Lymphangiography was performed because of extension of the tumor through the tunica albuginea into the adjacent adherent scrotum at the site of previous testicular biopsy. The lymphangiogram proved to be falsely positive following retroperitoneal lymph node dissection. The patient has remained clinically free of tumor for eight years.

Adult

Canine testicular tumors: epidemiologic features of 410 dogs.

Histologically confirmed testicular tumors were diagnosed in 410 dogs from 12 North American veterinary university hospitals and clinics. Three tumor-cell types, Sertoli cell tumor, interstitial cell tumor and seminoma, were about equally represented. Several breeds were identified with high risk for different testicular tumor-cell types. Cytogenetic and immunogenetic studies of these dog families could offer leads applicable to familial testicular cancer in man. The multiplicity of breeds within the series suggests that, as in man, other factors, in addition to hereditary, play a role in etiology. Cryptorchid dogs appear to have a 13.6 times higher risk of testicular tumor than normal dogs. Additionally, male dogs with an inguinal hernia have an increased risk (4.7) of testis tumors. There were no detectable excesses of other urogenital anomalies or urogenital tumors among the series. The Shetland Sheepdog is suggested as an appropriate model for research into the mechanisms responsible for testicular maldescent and tumorigenesis.

Age Factors

[A Sertoli-Leydig cell tumor as an incidental finding in a 72 year old patient].

In a 72-year old patient a total hysterectomy and bilateral salpingo-oophorectomy were performed because of a proliferating serous cystadenofibroma of the right ovary. A small but typical Sertoli-Leydig cell tumor was incidentaly found in the left ovary. The clinical and histological features of this unusual case are briefly presented.

Aged

Sertoli-Leydig cell tumor in a chimpanzee.

Microscopic analysis of a 38-year-old chimpanzee (Pan troglodytes) revealed a well differentiated Sertoli-Leydig cell tumor (arrhenoblastoma), 4 mm in diameter. Extensive follicular atresia and thecal hypertrophy were noted. The endometrium showed extensive adenomatous hyperplasia, an indication of hyperestrinism. It was suggested that the apparent excessive estrogenic secretion might have originated in the hypertrophic thecal tissue rather than in the tumor.

Animals

Estrogen biosynthesis in the ovaries and testes.

This review has presented some of our recent data on estrogen biosynthesis and has drawn upon these, as well as numerous observations, to design the two-cell type, two-gonadotropin model, applicable to both sexes, for the biosynthesis of gonadal estrogens and its regulation. Some of the data upon which this model, depicted in Figure 15, are based are quite preliminary and in many cases have been derived from experiments with tissues from animals over a rather narrow age span. Consequently, in future years this model may appear too simplistic to explain gonadal estrogen synthesis at all stages of development. However, whatever the fate of the model, whether it be broken and rebuilt on firmer foundations or furnished more lavishly, it is hoped that it will result in some of the corners being "rounded." There has been an emphasis on some of the similarities between the two sexes with respect to enzyme capacities, hormone receptors, and control mechanisms for the various cell types in the ovaries as compared to the testes. In particular, the striking similarities both structurally and functionally between Sertoli cells and granulosa cells are now recognized. Vive la difference.

Animals

An immunohistological study of steroid localization in Sertoli-Leydig tumors of the ovary and testis.

Nine ovarian Sertoli-Leydig tumors, showing varying degrees of differentiation, one pure ovarian Sertoli cell tumor, and one poorly differentiated stromal tumor of the testis, were examined for the presence of testosterone, estradiol and progesterone with an indirect immunoperoxidase method on formalin fixed paraffin embedded tissue. Clinically all nine patients with Sertoli-Leydig tumors had evidence of increased androgen production, manifested by either hirsutism or virilization; elevated serum testosterone was found in all four patients in whom it was measured. The patients with the pure ovarian Sertoli cell and testicular tumors were asymptomatic except for the presence of a mass. Testosterone was identified in Leydig cells in nine instances, in Sertoli cells in six, and in poorly differentiated spindle cells resembling the mesenchyme of the embryonic gonad in two. Cells with vacuolated cytoplasm, both Sertoli and Leydig cells, though positive for lipid were consistently negative for testosterone. Estradiol was present in Leydig cells in nine instances, in Sertoli cells in five, and in primitive gonadal stomal cells in two. The pattern of distribution was similar to that of testosterone but the intensity of the reaction for estradiol was generally less than that for testosterone. Progesterone was identified in Sertoli cells in one instance and was weakly positive in Leydig cells in three instances. The presence of testosterone and estradiol in both Sertoli and Leydig cells as well as in primitive spindle cells resembling those found in the embryonic gonad suggests that the latter cell is the precursor for both Sertoli and Leydig cells.

Adolescent

A cohort study of canine testicular neoplasia.

A prospective epidemiologic study of canine testicular neoplasia was undertaken in the Philadelphia area in 1971, with the cooperation of private veterinary practitioners. By the end of 1975, 938 dogs had been monitored for an average of 2 years. The cohort consisted of 609 cryptorchid and 329 age- and breed-matched controls. The incidence of testicular neoplasia in the cryptorchid subcohort was 12.7/1,000 dog-years at risk. Testicular neoplasms did not develop in controls. A large proportion of the dogs were below the average age at onset for this neoplasm. Among dogs over 6 years of age, the incidence was 68.1/1,000 dog-years at risk. The incidence of Sertoli cell tumors and seminoma was approximately twice as high in dogs with unilaterally retained inguinal testicles as in abdominal cryptorchids. Sertoli cell tumors developed in 10 dogs and seminoma developed in 6. One half of the testicular neoplasms that developed did so within the first year of observation. This study demonstrated the feasibility of conducting prospective epidemiologic studies of canine diseases with the assistance of practicing veterinarians.

Animals