Case Study #2
A 32 year old male, non-drinker and non-smoker, complains of heaviness in his lower abdominal region. This has been noted for two months and he doesn't recall any trauma to the region. Upon examination, a 3-cm firm mass is found in the right scrotum. No lymphadenopathy is seen, and a scrotal ultrasound confirms the presence of a solid testicular mass. A radical orchiectomy is performed and histology is below. What is the diagnosis?
Click this symbol for a hint.
Tumor shows a diffuse pattern interrupted by fibrous septa with lymphocytic infiltrate. Seminiferous tubules are visible on the right.
At a higher magnification, tumor cells show clear cytoplasm with round polygonal nuclei and large nucleoli.
Neoplastic cells are negative for inhibin
, but inhibin positivity are seen in Sertoli cells as well as in the Leydig cells shown on the right.
Tumor cells show strong diffuse positivity for PLAP
suggesting the neoplasm is of germ cell origin.
Tumor cells show strong diffuse nuclear positivity for SALL4
further confirming the neoplasm is of germ cell origin.
Neoplastic cell nuclei are negative for embryonal carcinoma marker SOX-2
The tumor cells do not express CD30
, making embryonal carcinoma less likely.
Neoplastic cells show strong diffuse nuclear positivity, suggesting possibly either a seminoma or a embryonal carcinoma.
Neoplastic cells show strong diffuse nuclear positivity, further suggesting seminoma.