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Stromal Tumors
Kyle K. Jensen, MDShweta Bhatt, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Gonadal stromal tumors: a.k.a. non-germ cell tumors, interstitial cell tumors, or sex cord tumors
            • Definitions

              • Neoplasm (often benign) arising from non-germ cell elements
              • Leydig cell tumor (LCT): Arises from interstitial cells
              • Sertoli cell tumor (SCT): Arises from sustentacular cells lining seminiferous tubules
              • Uncommon stromal tumors: Granulosa cell, fibroma-thecoma, gonadoblastoma

            IMAGING

            • General Features

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Gentile G et al: Testis sparing surgery of small testicular masses: retrospective analysis of a multicenter cohort. J Urol. 203(4):760-6, 2020
                                  2. Khanna M et al: Diagnostic performance of multi-parametric MRI to differentiate benign sex cord stromal tumors from malignant (non-stromal and stromal) testicular neoplasms. Abdom Radiol (NY). 46(1):319-30, 2020
                                  3. Sharbidre KG et al: Imaging of scrotal masses. Abdom Radiol (NY). 45(7):2087-108, 2020
                                  4. Paffenholz P et al: Testis sparing surgery for benign testicular masses: diagnostics and therapeutic approaches. J Urol. 200(2):353-60, 2018
                                  5. Maxwell F et al: Colour Doppler and ultrasound characteristics of testicular Leydig cell tumours. Br J Radiol. 89(1062):20160089, 2016
                                  6. Manganaro L et al: A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours. Eur Radiol. 25(12):3586-95, 2015
                                  7. Isidori AM et al: Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitative contrast-enhanced US of benign and malignant testicular tumors. Radiology. 273(2):606-18, 2014
                                  8. Sommers D et al: Ultrasonography evaluation of scrotal masses. Radiol Clin North Am. 52(6):1265-81, 2014
                                  9. Miliaras D et al: Adult type granulosa cell tumor: a very rare case of sex-cord tumor of the testis with review of the literature. Case Rep Pathol. 2013:932086, 2013
                                  10. Cantisani V et al: Contrast-enhanced ultrasonographic (CEUS) and elastosonographic features of a case of testicular Leydig tumor. Ultraschall Med. 33(5):407-9, 2012
                                  11. Leonhartsberger N et al: Increased incidence of Leydig cell tumours of the testis in the era of improved imaging techniques. BJU Int. 108(10):1603-7, 2011
                                  12. Tallen G et al: High reliability of scrotal ultrasonography in the management of childhood primary testicular neoplasms. Klin Padiatr. 223(3):131-7, 2011
                                  13. Zugor V et al: Congenital juvenile granulosa cell tumor of the testis in newborns. Anticancer Res. 30(5):1731-4, 2010
                                  14. Sajadi KP et al: Sex cord-gonadal stromal tumor of the rete testis. Adv Urol. PubMed Central PMCID: PMC2612754, 2009
                                  15. Peterson C et al: Prenatal diagnosis of juvenile granulosa cell tumor of the testis. J Pediatr Urol. 4(6):472-4, 2008
                                  16. Maizlin ZV et al: Leydig cell tumors of the testis: gray scale and color Doppler sonographic appearance. J Ultrasound Med. 23(7):959-64, 2004
                                  17. Carmignani L et al: High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol. 170(5):1783-6, 2003
                                  18. Woodward PJ et al: From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 22(1):189-216, 2002
                                  19. Ulbright TM et al: Tumors of the testis, adnexa, spermatic cord, and scrotum. In: Atlas of Tumor Pathology, fasc 25, ser 3. Armed Forces Institute of Pathology. 1-290, 1999
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Pathology

                                        • Clinical Issues

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Synonyms

                                              • Gonadal stromal tumors: a.k.a. non-germ cell tumors, interstitial cell tumors, or sex cord tumors
                                            • Definitions

                                              • Neoplasm (often benign) arising from non-germ cell elements
                                              • Leydig cell tumor (LCT): Arises from interstitial cells
                                              • Sertoli cell tumor (SCT): Arises from sustentacular cells lining seminiferous tubules
                                              • Uncommon stromal tumors: Granulosa cell, fibroma-thecoma, gonadoblastoma

                                            IMAGING

                                            • General Features

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Gentile G et al: Testis sparing surgery of small testicular masses: retrospective analysis of a multicenter cohort. J Urol. 203(4):760-6, 2020
                                                                  2. Khanna M et al: Diagnostic performance of multi-parametric MRI to differentiate benign sex cord stromal tumors from malignant (non-stromal and stromal) testicular neoplasms. Abdom Radiol (NY). 46(1):319-30, 2020
                                                                  3. Sharbidre KG et al: Imaging of scrotal masses. Abdom Radiol (NY). 45(7):2087-108, 2020
                                                                  4. Paffenholz P et al: Testis sparing surgery for benign testicular masses: diagnostics and therapeutic approaches. J Urol. 200(2):353-60, 2018
                                                                  5. Maxwell F et al: Colour Doppler and ultrasound characteristics of testicular Leydig cell tumours. Br J Radiol. 89(1062):20160089, 2016
                                                                  6. Manganaro L et al: A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours. Eur Radiol. 25(12):3586-95, 2015
                                                                  7. Isidori AM et al: Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitative contrast-enhanced US of benign and malignant testicular tumors. Radiology. 273(2):606-18, 2014
                                                                  8. Sommers D et al: Ultrasonography evaluation of scrotal masses. Radiol Clin North Am. 52(6):1265-81, 2014
                                                                  9. Miliaras D et al: Adult type granulosa cell tumor: a very rare case of sex-cord tumor of the testis with review of the literature. Case Rep Pathol. 2013:932086, 2013
                                                                  10. Cantisani V et al: Contrast-enhanced ultrasonographic (CEUS) and elastosonographic features of a case of testicular Leydig tumor. Ultraschall Med. 33(5):407-9, 2012
                                                                  11. Leonhartsberger N et al: Increased incidence of Leydig cell tumours of the testis in the era of improved imaging techniques. BJU Int. 108(10):1603-7, 2011
                                                                  12. Tallen G et al: High reliability of scrotal ultrasonography in the management of childhood primary testicular neoplasms. Klin Padiatr. 223(3):131-7, 2011
                                                                  13. Zugor V et al: Congenital juvenile granulosa cell tumor of the testis in newborns. Anticancer Res. 30(5):1731-4, 2010
                                                                  14. Sajadi KP et al: Sex cord-gonadal stromal tumor of the rete testis. Adv Urol. PubMed Central PMCID: PMC2612754, 2009
                                                                  15. Peterson C et al: Prenatal diagnosis of juvenile granulosa cell tumor of the testis. J Pediatr Urol. 4(6):472-4, 2008
                                                                  16. Maizlin ZV et al: Leydig cell tumors of the testis: gray scale and color Doppler sonographic appearance. J Ultrasound Med. 23(7):959-64, 2004
                                                                  17. Carmignani L et al: High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol. 170(5):1783-6, 2003
                                                                  18. Woodward PJ et al: From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 22(1):189-216, 2002
                                                                  19. Ulbright TM et al: Tumors of the testis, adnexa, spermatic cord, and scrotum. In: Atlas of Tumor Pathology, fasc 25, ser 3. Armed Forces Institute of Pathology. 1-290, 1999