Simultaneous Sertoli Cell Tumor and Adenocarcinoma of the Tunica Vaginalis Testis in a Patient with Testicular Feminization

Abstract

Background. The association of testicular feminization with late diagnosis in a patient with a large Sertoli cell tumor and a metastasizing adenocarcinoma of the tunica vaginalis testis is unusual.Case. Testicular feminization was diagnosed in a 72-year-old patient, who was admitted with a large lower abdominal mass. Histologically, we found a well-differentiated Sertoli cell tumor and an adenocarcinoma of the tunica vaginalis testis with metastases in the sigmoid colon, rectum, and omentum. Explorative laparotomy revealed a large pelvic tumor mass and extensive peritoneal carcinosis. After debulking surgery to optimal residual disease and four courses of chemotherapy (cisplatin and etoposide), there was no evidence of disease (clinically) for 24 months before an intraabdominal and inguinal relapse occurred. Due to the unwillingness of the patient to receive salvage chemotherapy or palliative abdominal surgery, the disease progressed rapidly and she died 27 months after the initial operation.Conclusion. This is the first reported case of an advanced carcinoma of the tunica vaginalis testis occurring simultaneously with a large Sertoli cell tumor in a patient with testicular feminization. Surgical debulking and platinum-based chemotherapy rendered the patient clinically free of disease for 2 years.