Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature

Abstract Background Sex cord gonadal stromal tumors compose less than 10% of all testicular neoplasms and consist of a variety of histological subtypes. In 2016, the World Health Organization introduced a novel subtype, the myoid gonadal stromal tumor, that consists of spindle-shaped cells with immu...

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Main Authors: Klaus-Peter Dieckmann, Lars Tharun, Markus Angerer, Alexander Harms, Christian Wülfing
Format: Article
Language:English
Published: BMC 2024-02-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-024-04393-7
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author Klaus-Peter Dieckmann
Lars Tharun
Markus Angerer
Alexander Harms
Christian Wülfing
author_facet Klaus-Peter Dieckmann
Lars Tharun
Markus Angerer
Alexander Harms
Christian Wülfing
author_sort Klaus-Peter Dieckmann
collection DOAJ
description Abstract Background Sex cord gonadal stromal tumors compose less than 10% of all testicular neoplasms and consist of a variety of histological subtypes. In 2016, the World Health Organization introduced a novel subtype, the myoid gonadal stromal tumor, that consists of spindle-shaped cells with immunohistologic features of muscle cells. Only few cases have been reported to date. Due to its rarity and owing to its only recent introduction, the current knowledge about myoid gonadal stromal tumor is limited, and particularly, appropriate clinical management is still ill-defined. Case presentation A 47-year-old man of Caucasian descent presented with nonspecific scrotal discomfort. A roundish and well demarcated hypoechoic mass of 8.5 mm in diameter was detected in the cranial region of the left testis. Serum tumor marker levels were within normal ranges. Testis-sparing surgery revealed a 9-mm whitish, hard mass with sharp surgical margin. Histologically, the neoplasm consisted of microfibrillar tissue with spindle-shaped cells harboring elongated nuclei. Immunohistochemical work-up disclosed expression of desmin, small muscle actin, and S100 protein giving evidence for the myogenic nature of the neoplastic cells. There was no indication of malignancy, neither histologically nor clinically. Follow-up of 1 year was uneventful. Conclusion A literature survey revealed 22 previous cases of myoid gonadal stromal tumor. The median age was 37 years, the median size of the neoplasm was 20 mm, and there was no side-preponderance. Myoid gonadal stromal tumor is not much different from other subtypes of gonadal stromal tumors nor from testicular gem cell tumors regarding age and laterality; however, tumor size is smaller in myoid gonadal stromal tumors than in germ cell tumors. Although rarely performed so far, testis-sparing surgery probably constitutes an appropriate treatment of this neoplasm. Myoid gonadal stromal tumor represents an emerging novel entity of benign testicular new growths that caregivers of patients with testicular tumors should be aware of.
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spelling doaj.art-6a3dc8452a984e349723d90393a69dd22024-03-05T19:14:17ZengBMCJournal of Medical Case Reports1752-19472024-02-011811710.1186/s13256-024-04393-7Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literatureKlaus-Peter Dieckmann0Lars Tharun1Markus Angerer2Alexander Harms3Christian Wülfing4Testicular Cancer Unit, Department of Urology, Asklepios Klinik AltonaMedizinisches Versorgungszentrum Hanse HistologikumTesticular Cancer Unit, Department of Urology, Asklepios Klinik AltonaMedizinisches Versorgungszentrum Hanse HistologikumTesticular Cancer Unit, Department of Urology, Asklepios Klinik AltonaAbstract Background Sex cord gonadal stromal tumors compose less than 10% of all testicular neoplasms and consist of a variety of histological subtypes. In 2016, the World Health Organization introduced a novel subtype, the myoid gonadal stromal tumor, that consists of spindle-shaped cells with immunohistologic features of muscle cells. Only few cases have been reported to date. Due to its rarity and owing to its only recent introduction, the current knowledge about myoid gonadal stromal tumor is limited, and particularly, appropriate clinical management is still ill-defined. Case presentation A 47-year-old man of Caucasian descent presented with nonspecific scrotal discomfort. A roundish and well demarcated hypoechoic mass of 8.5 mm in diameter was detected in the cranial region of the left testis. Serum tumor marker levels were within normal ranges. Testis-sparing surgery revealed a 9-mm whitish, hard mass with sharp surgical margin. Histologically, the neoplasm consisted of microfibrillar tissue with spindle-shaped cells harboring elongated nuclei. Immunohistochemical work-up disclosed expression of desmin, small muscle actin, and S100 protein giving evidence for the myogenic nature of the neoplastic cells. There was no indication of malignancy, neither histologically nor clinically. Follow-up of 1 year was uneventful. Conclusion A literature survey revealed 22 previous cases of myoid gonadal stromal tumor. The median age was 37 years, the median size of the neoplasm was 20 mm, and there was no side-preponderance. Myoid gonadal stromal tumor is not much different from other subtypes of gonadal stromal tumors nor from testicular gem cell tumors regarding age and laterality; however, tumor size is smaller in myoid gonadal stromal tumors than in germ cell tumors. Although rarely performed so far, testis-sparing surgery probably constitutes an appropriate treatment of this neoplasm. Myoid gonadal stromal tumor represents an emerging novel entity of benign testicular new growths that caregivers of patients with testicular tumors should be aware of.https://doi.org/10.1186/s13256-024-04393-7Testicular neoplasmGonadal stromal tumorTestis-sparing surgeryDesminS100 proteinSmooth muscle actin
spellingShingle Klaus-Peter Dieckmann
Lars Tharun
Markus Angerer
Alexander Harms
Christian Wülfing
Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature
Journal of Medical Case Reports
Testicular neoplasm
Gonadal stromal tumor
Testis-sparing surgery
Desmin
S100 protein
Smooth muscle actin
title Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature
title_full Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature
title_fullStr Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature
title_full_unstemmed Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature
title_short Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature
title_sort myoid gonadal stromal tumor of the testis the novel subtype of testicular gonadal stromal tumors a case report and review of the literature
topic Testicular neoplasm
Gonadal stromal tumor
Testis-sparing surgery
Desmin
S100 protein
Smooth muscle actin
url https://doi.org/10.1186/s13256-024-04393-7
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