Sex Cord-stromal Cell Research Articles

The Amalgamated Sophomore-Gonadoblastoma

Gonadoblastoma emerges as a benign gonadal neoplasm composed of germ cells and descendants of sex cord-stromal cells reminiscent of immature granulosa cells and Sertoli cells. Neoplasm is preponderantly associated with disorders of sexual development wherein majority (~80%) of neoplasms articulate phenotypic females. Tumefaction expounds primary amenorrhea and delayed sexual maturation with delayed development of genitalia and emergence of secondary sexual characters. Gonadoblastoma locus appears to be situated adjacent to Y centromere wherein TSPY gene is implicated in carcinogenesis. Commonly discerned distinct morphological configurations appear comprised of spherical or irregular clusters of immature Sertoli cells admixed with germ cells and circumscribing basement membrane. Intervening stroma exhibits enlarged, polygonal cells simulating Leydig cells admixed with focal calcification. Germ cells appear immune reactive to p53, placental alkaline phosphatase (PLAP), CD117/c-KIT and VASA protein or encoded testis specific Y protein. Testicular gonadoblastoma requires segregation from neoplasms such as Sertoli cell tumour. Genetic karyotyping is an essential investigation for distinguishing individuals with intersex disorders and potential occurrence of gonadoblastoma. Surgical extermination is a recommended mode of therapy for alleviating gonadoblastoma.

Bilateral Gonadoblastoma in a 13-Year-Old Female with Turner Syndrome and Y Chromosome: A Case Report

Abstract Introduction/Objective Gonadoblastoma is a relatively rare type of ovarian tumor that has a high risk for patients with 45X/46XY. It is derived from the Y chromosome at its long arm GBY region, which contains the most likely candidate gene called testis-specific protein Y-encoded (TSPY). Methods/Case Report In this case report, we present a case of a 13-year-old girl with Turner syndrome whose cytogenetic test showed 45X with monosomy X and a siodicentric Yq chromosome. As she carried a high risk for the development of gonadoblastoma due to the presence of the Y chromosome and clinically had premature ovarian failure, she received further imaging studies, which did not reveal obvious ovarian masses. She underwent resections of bilateral fallopian tubes and ovaries. Bilateral fallopian tubes were unremarkable. However, within the bilateral ovarian tissue, foci of gonadoblastoma were found (0.5 to 0.6 cm), composed of large round germ cells (confirmed by positive OCT 3/4 and SALL4 stains) intermingled with oval-shaped sex cord-stromal cells forming tubular/cribriform structures (confirmed by positive staining for inhibin, calretinin, and FOXL2). The stromal cells of gonadoblastoma, but not germ cells, were positive for androgen receptor staining, while both components were negative for estrogen receptor staining. No invasive germ cell tumor or sex cord tumor was present. Results (if a Case Study enter NA) N/A Conclusion The positive androgen receptor staining in stromal cells of the gonadoblastoma supports the view that the Y chromosome-driven androgen system may play a role in the development of gonadoblastoma in a bi-cellular pattern.

Follicular Fibroma Combined with Lymphoma: A Case Report and Literature Review

Follicular theca fibroma is a benign tumor originating from ovarian sex cord stromal cells [1]. Due to the coexistence of follicular theca cells and fibroma

Treatment and survival of patients with malignant ovarian sex cord-stromal cell tumours: An analysis of the Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO) study group CORSETT database.

Malignant sex cord-stromal cell tumours (SCST) account for only 7% of ovarian malignancies. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) study group has established a clinicopathological database to provide an overview of the current treatment strategies and survival of SCST patients and to identify research needs. Twenty centres provided mixed retro- and prospective data of patients with tumour specimens and second-opinion pathology review treated between 2000 and 2014. Descriptive analyses of treatment strategies, Kaplan-Meier curves and cox regression analyses were conducted. Two hundred and sixty-two SCST patients were included. One hundred and ninety-one Granulosa-cell tumour (GCT) and 17 Sertoli-Leydig cell tumour (SLCT) patients were stage I disease (>80%). Forty four GCT (18.7%) and two (8.3%) SLCT patients received adjuvant systemic treatment. After a median observation time of 78.2 months, 46% of all SCST patients experienced disease recurrence, treated predominantly with secondary debulking surgery (> 90%). Advanced FIGO stage, lymph node involvement and intra-operative capsule rupture were associated with disease recurrence on univariate analysis (all p < 0.05). Median OS time was not reached. In this analysis of SCST patients, adjuvant chemotherapy was unable to prevent disease recurrence. Despite high recurrence rates, overall survival rates were excellent.

A RARE CASE OF BILATERAL OVARIAN FIBROMA ARISING FROM OVARIAN STROMA: HISTOPATHOLOGY CASE REPORT

INTRODUCTION: Ovarian fibroma is a solid tumor that belongs to sex-cord stromal cell tumor of ovary commonest benign tumor of ovarian stroma. A 43-year-old female admitted in obstetric and gynecology CASE REPORT: department with complain of abdominal pain for 2 months and heavy menses. Ovarian fibroma are DISCUSSION: common benign ovarian tumor accounts for approximately 1-4% of ovarian tumor usually unilateral but bilateral ovarian fibroma is rare entity. Large ovarian fibroma can be associated with ascites and right sided pleural effusion (Meigs syndrome).

A rare case report: testicular leydig cell tumor with gynecomastia

Gynecomastia is the most common definition of breast tissue growth. It is common in urology due to androgen blockade used in prostate cancers. Clinically insignificant gynecomastia is present in 50% of men and there is no proliferation of breast tissue in ductus epithelium. Gynecomastia is rarely seen in primary testicular tumors such as Leydig Cell Tumors (LCT). Leyındg Cell Tumors are one of the rare sex cord stromal cell tumors of the testis . Although it is usually with endocrine changes, it is a painless mass or incidentally occurring tumor in the testis. In this case report, we examined the left testicle cell tumor of the gynecomastia at the age of 43 years. He had been admitted to our clinic for gynecomastia and breast pain for 6 years. The patient was followed-up by endocrinology due to the aforementioned complaints. The patient was suspected of prolactinoma. Physical examination revealed no MRI. MRI, heterogenous hyperintense in T2A with mild lobulated contoured T2A with a hypointense capsule in T2A with well limited T2A in the left intratesticular area, and heterogeneous isohaphy hyperintense internal T1A in the form of a nodular lesion (testicular tumor) showing intense and heterogeneous contrast enhancement commented. The patient underwent left inguinal orchiectomy and the pathology report was negative for the leyding cell tumor and surgical margin.&#x0D; Leydig cell tumors are the most common spermatic cord / stromal tumors. About 30% of patients present with gynecomastia. Ultrasonography is accepted as the first research method for the diagnosis of leydic cell tumor, but MRI is superior to ultrasonography in diagnosis. The gold standard treatment option is radical inguinal orchiectomy. The mechanism of hormonal disorders may be an overproduction of testosterone and estrogens by the tumor. As in our case, it is necessary to consider the possibility of LCT which is rarely seen in patients with gynecomastia and to provide differential diagnosis by performing the tests in this direction.

Cutaneous metastasis of juvenile-type granulosa cell tumor

Granulosa Cell Tumors (GCT) of ovary is a malignant tumor originating from sex cord stromal cells.

121 Steroid cell tumor of the ovary

Ovarian steroid cell tumors are rare. They are fewer than 5 percent of sex-cord stromal tumors and comprised of 0.1% of all ovarian tumors. The average age at diagnosis is the mid-twenties, but patients can present at virtually any age. This is a case of a 19-year-old nulligravid with secondary amenorrhea, excessive hair growth and deepening of the voice. Ultrasonography of the pelvic structures revealed a right ovarian new growth, a 2.4 × 2.3 × 2.2 cm solid mass. Tumor markers results are within normal limits. An exploratory laparotomy with frozen section biopsy was planned. Incidentally, there was a note of blood pressure elevation to 150–160/80–90, preoperatively and intraoperatively. The right adnexal solid mass of the ovary was submitted for frozen section which revealed sex cord stromal tumor. After resection of the mass, the blood pressure ranges from 120–130/60–80. Final biopsy revealed a sex cord stromal tumor favor steroid cell tumor, not otherwise specified. The patient was discharged and advised for follow up. Upon follow up, she is now normotensive, and there was a note of resolution of the symptoms of voice changes and regularization of the menstrual cycle pattern.

A rare collision tumor of ovary – Mucinous cystadenoma with adult granulosa cell tumor

Though collision tumors have been reported earlier like serous cystadenoma and mature cystic teratoma, combination of mucinous cystadenoma and adult granulosa cell tumor is rarely reported in the literature. Collision tumors lack the histological cellular intermingling which is seen in composite tumors. Both involve two morphologically and immunohistochemically distinct neoplasms coexisting within a single organ. Mucinous cystadenoma is a benign cystic surface epithelial tumor of ovary. Granulosa cell tumor(GCT) is a low grade malignancy arising from sex cord stromal cells of ovary and need a close follow up for recurrences which may be late. Here we present a case of 50 year old female who presented with lower abdominal pain. Patient underwent staging laporotomy and ovarian specimen sent for histopathological examination, where it was diagnosed as mucinous cystadenoma coexisting with adult granulosa cell tumor. This case report emphasis upon the fact that multiloculated cyst have to be extensively examined grossly, so as not to miss any solid component which might have a bearing on prognosis of the patient. Here the association of mucinous cystadenoma and granulosa cell tumor need close follow up of patient.

Demographic features, clinical characteristics, and prognostic factors of non-epithelial ovarian tumors at Princess Noorah Oncology Center, National Guard Hospital, Jeddah, Saudi Arabia.

Objectives:To reveal the demographic features, prognostic factors, and tumor characteristics of patients with non-epithelial ovarian tumors (NEOTs).Methods:This cross-sectional study was performed using data from all female patients diagnosed with NEOT (germ cell [GC], sex cord–stromal cells [SCSC], sarcoma, and small cell carcinoma) from 2002 to 2017 at Princess Noorah Oncology Center, National Guard Hospital Jeddah, Saudi Arabia.Results:Forty patients with NEOTs were identified. There were equal percentages of GC (45%) and SCSC (45%) origin tumors, and these were the most common histological types. The remaining tumors were sarcomas. Germ cell tumors were more common in younger patients, while SCSC tumors were more frequent in the older age group.Conclusion:The findings for protective and risk factors were inconclusive. Patients with GC tumors had better survival outcomes than those with the other subtypes.

Clinical Characterization of Patients with Ovarian Mass Combined with Dysplasia of Secondary Sexual Characteristics

Objective To investigate the clinical characteristics of preadolescent and adolescent female patients with ovarian mass combined with dysplasia of secondary sexual characteristics. Methods This study retrospectively analyzed 18 cases of ovarian mass combined with dysplasia of secondary sexual characteristics aged 0-19 years admitted to Peking Union Medical College Hospital from January 2012 to November 2019.By analyzing the clinical manifestations,surgical methods,postoperative pathology,therapies and prognosis of the cases,we summarized the diagnosis and treatment ideas. Results Among the 18 cases,7(7/18,38.9%)developed secondary sex signs before puberty,including 5 cases showing precocity(including 2 cases of juvenile granulosa cell tumor,1 case of gonadoblastoma,1 case of ovarian follicular cyst,and 1 case of 46,XY simple gonadal dysplasia combined with dysgerminoma)and 2 cases presenting masculine manifestations(1 case of steroid cell tumor and 1 case of sclerosing stromal tumor).The rest 11(11/18,61.1%)cases showed abnormal development of secondary sexual characteristics during puberty,including 8 cases with masculine manifestations or abnormal menstruation after menarche(7 cases with sex cord stromal cell tumor and 1 case with cystic granulosa cell tumor),2 cases with primary amenorrhea(1 case with androgen insensitivity syndrome combined with testicular sertoli cell tumor and 1 case with endometriosis cyst combined with reproductive tract malformation),and 1 case diagnosed as 46,XX gonadal dysplasia with serous cystadenoma and no secondary sexual development during puberty. Conclusions Sex hormone levels should be actively tested in the case of prepubertal secondary sexual characteristics appearing early,pubertal secondary sexual characteristics being abnormal(underdevelopment),and/or menstrual abnormalities.Imaging examination should be performed to exclude ovarian organic lesions,and chromosome karyotype analysis should be performed if necessary.The diagnosis of ovarian mass in preadolescent and adolescent females with related symptoms should first be alerted to cord stromal cell tumor.It is recommended to rule out the possibility of combined reproductive tract malformation in the adolescent patients with primary amenorrhea.Chromosome examination should be conducted to rule out the possibility of gonadal dysplasia in the adolescent patients with primary amenorrhea and/or no development of secondary sexual characteristics.

Clinical and pathological patterns of non-epithelial malignant ovarian tumours in Western Saudi Arabia.

To report a single-center experience in non-epithelial malignant ovarian tumours (NEMOT), by presenting different clinical and pathological characteristics, management and outcomes. We retrospectively reviewed electronic files of all female patients who underwent surgery for NEMOT at the Gynecology Department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from July 2003 to July 2019. We collected baseline demographic, anthropomorphic and clinical data; pathological characteristics; management and follow-up data; and outcomes including residual disease, recurrence and last follow-up status (deceased or alive). Thirty-three women were included; mean (standard deviation) age = 33.24 (17.72) years, range = 4, 86 years. Granulosa cell tumor was the most frequent subtype diagnosed in 17 (51.5%) patients, followed by germ cell tumours 13 (39.4%). The majority of patients were diagnosed at FIGO Stage I (22, 66.7%) and with tumor Grade 1 (23, 69.7%), while 8 (24.2%) were diagnosed with Grade 3 tumors. Granulosa cell and Sertoli-Leydig cell tumours were diagnosed at an older age (mean age = 39.30 vs. 23.92 years) compared to germ cell tumours, respectively (P = 0.012). Two-third of the patients benefited from conservative surgery including oophorectomy + staging, and 16 (48.5%) benefited from chemotherapy with bleomycin, etoposide and platinum being the most common protocol (13, 39.4%) for germ cell tumours. Postoperatively, only 2 (6.1%) patients had residual disease. Recurrence and mortality were reported in one and four patients, respectively, resulting in recurrence rate = 3.0% (95% confidence interval [CI] = 0.01%, 15.8%) and mortality rate = 12.1% (95% CI = 3.4%, 28.2%). The present series of NEMOT was predominated by sex cord-stromal cell tumors, which were diagnosed in patients with older age, while germ cell tumours were underrepresented. Although survival rates were comparable to those reported internationally, more consideration should be given to following up patients regarding fertility outcomes to provide a more comprehensive evaluation of treatment success and quality of care.

772P Hormonal therapy in pretreated patients with metastatic or refractory ovary granulosa cell tumor

Granulosa cell tumor is a malignant neoplasm that arises from the ovarian sex-cord stromal cell. Surgery is the primary treatment. Recurrence ratios are high in patients who had stage IC or over. In this study, we aimed to assess the efficacy of hormonal therapy in pretreated patients with metastatic or refractory ovary granulosa cell tumors.

Comparison of Frozen and Permanent Section Diagnosis in Ovarian Neoplasms: Analysis of Factors Affecting Accuracy.

Ovarian cancer is the seventh most common form of cancer among women worldwide. The aim of the study was to determine the accuracy of a frozen section and the factors affecting the accuracy of frozen diagnosis of ovarian neoplasms. This retrospective, cross-sectional study was conducted on 401 patients with ovarian masses with frozen section diagnosis in Shahid Faghihi Hospital affiliated to Shiraz University of Medical Sciences between 2014 and 2018. Each ovarian tumor sample was evaluated for histopathologic diagnosis using frozen and paraffin-embedded sections, which were reviewed by an expert gynecologic pathologist. Accuracy and diagnostic values were estimated by comparing the results of the 2 techniques, using the paraffin section as the gold standard. The overall accuracy of the frozen section was 94.5%. Its sensitivity was 85.3% for malignant, 88.2% for borderline, and 99.6% for benign tumors. Its specificity was also 99.7% for malignant, 98.0% for borderline, and 90.9% for benign tumors. The positive predictive value was 98.9% for malignant, 86.5% for borderline, and 94.6% for benign tumors. Most false negatives occurred in mucinous and borderline tumors. The sensitivity of malignant tumors of germ cell and sex cord-stromal cell types were 64.3% and 95.5%, respectively. The specificity of germ cell and sex-cord stromal tumors were 100% and 93.8%, respectively. Frozen section seems to be a precise technique for histopathologic diagnosis of ovarian tumors. However, borderline and mucinous tumors are the most problematic issues during frozen section diagnosis and malignant germ cell tumors have the lowest sensitivity.

Testicular Tumors: A Contemporary Update on Morphologic, Immunohistochemical and Molecular Features

Testicular tumors are incredibly diverse and one of the most challenging areas in surgical pathology. Because of the rarity and overlapping features with numerous entities occurring in the testis and paratestis, these tumors pose a diagnostic challenge even to the most experienced general pathologists. In 2016, the latest "World Health Organization (WHO) classification of testicular tumors" was released, which incorporated several updates to the previous 2004 classification system. These updates involved several entities, including germ cell tumors, sex cord-stromal tumors, tumors containing both germ cells and sex-cord stromal cells, a miscellaneous group of testicular tumors and paratesticular tumors. In addition, significant changes were also introduced in the 2018 AJCC TNM staging (8th edition) regarding testicular tumors. The germ cell tumors are divided into 2 major groups; tumors derived from germ cell neoplasia in situ (GCNIS) and those unrelated to GCNIS. The GCNIS associated tumors include seminomatous and nonseminomatous germ cell tumors, which constitute a heterogeneous group of tumors. Non-GCNIS-associated tumors include prepubertal-type teratoma, prepubertal yolk sac tumor, mixed prepubertal-type teratoma and yolk sac tumor and spermatocytic seminoma. In the sex cord-stromal category, the tumors are classified based on their cells of origin. Most are Leydig cell tumors and Sertoli cell tumors; however, several mixed and diverse entities based on cell types are included in this group. Gonadoblastoma is the only tumor in the mixed germ cell and sex cord-stromal tumor category. Because of recent advances in molecular techniques, abundant new genetic information has emerged which helped classify the tumors based on the molecular alterations and provided insights into the tumor pathogenesis. This review focused on the updates related to testicular germ cell tumors and sex cord-stromal tumors and described the morphologic, immunohistochemical and molecular characteristics with an aim to provide a practical diagnostic approach and an update on relevant recent molecular advances.

Granulosa Cell Tumors of the Ovary: A Retrospective Tertiary Center Experience

Objective: Granulosa cell tumor (GCT) of the ovary is an uncommon neoplasm with good prognosis. GCT is a rare ovarian malignancy originating from sex cord-stromal cells. The only clinically proven prognostic factor regarding recurrence is stage. In this study, we aimed to analyze the detailed clinical and histopathological prognostic parameters of this rare malignancy, based on the cases we experienced in our own clinic. Material and Methods: Forty-six patients who were followed up and treated with the diagnosis of granulosa cell ovarian tumor between 2010 and 2020 were evaluated retrospectively by scanning the patient archive files. Results: The median follow-up period was 52 months. The mean patient age was 55 years. The most common symptom was abdominal pain. The most common surgical procedure was total abdominal hysterectomy+bilateral salpingo-oophorectomy+pelvic/paraaortic lymph node dissection with 60.9% (n=28). Fertility sparing surgery was performed for 5 (10.9%) patients. In this study, a significant relationship was found between the survival and FIGO stage, nuclear atypia, mitotic rate. The rate of metastatic lymph nodes is very low in primary surgery and therefore may not be performed. Conclusion: GCT is one of the rare diseases of ovary. Since recurrence may occur even after many years, the follow-up period should be kept long. Stage is still the most important prognostic factor and is directly related to survival. In addition, the mitotic rate and nuclear atypia of the tumor may also be prognostic factors and have an impact on survival.

Does uterine preservation affect survival outcomes of patients with stage I ovarian sex cord-stromal cell tumours? A multi-institutional study

ObjectiveSex cord-stromal tumours of the ovary are relatively uncommon neoplasms that account for 3 % of all ovarian cancers. Uterine preservation with careful staging is achievable; however, conservative surgery remains controversial. This study examined the prognostic effects of uterine preservation in patients with stage I sex cord-stromal tumours. Study designThis retrospective cohort study was undertaken between January 1986 and February 2019, and the clinicopathological data of 4897 women with malignant ovarian tumours were collected. Seventy-seven patients with stage I sex cord-stromal tumours were eligible for inclusion. The characteristics and survival outcomes of these patients were examined. To investigate the prognostic effects of uterine-preserving surgery, baseline imbalances between patients with and without uterine-preserving surgery were adjusted using an inverse probability of treatment weighting with propensity scores composed of independent clinical variables. ResultsThe mean ages of patients in the uterine-preserving surgery and non-uterine-preserving surgery groups were 39.8 and 57.8 years, respectively. After inverse probability of treatment weighting adjustments, no significant differences in overall survival (p = 0.205) or recurrence-free survival (p=0.071) were observed between the uterine-preserving surgery and non-uterine-preserving surgery groups. Estimated 10-year overall survival rates were 98.7 % in the uterine-preserving surgery group and 95.9 % in the non-uterine-preserving surgery group, and 10-year recurrence-free survival rates were 87.2 % in the uterine-preserving surgery group and 78.2 % in the non-uterine-preserving surgery group. Uterine-preserving surgery did not significantly affect the site of tumour recurrence. ConclusionUterine-preserving surgery may be a feasible surgical option for patients with stage I sex cord-stromal tumours. Further research is needed to guarantee prognostic accuracy and develop effective therapeutic approaches for sex cord-stromal tumours.

Systemic therapy for non-serous ovarian carcinoma.

Ovarian cancer is one of the top ten most common cancers in women around the world, with high-grade serous epithelial cancer being the most frequent type. However, around a quarter of cases consist of non-serous epithelial ovarian cancer (EOC), which is a heterogeneous group of malignancies that includes endometroid, mucinous, clear cell carcinoma (CCC), and carcinosarcoma. Another relevant group of nonepithelial tumors are those arising from germ cells or sex-cord stromal cells, which account for about 10% of all ovarian cancers. Although there are similarities in the presentation, evaluation, and management of these tumors, they have unique characteristics in terms of epidemiology, tumor biology, tumor marker expression, and response to treatment, warranting a different approach to each one of them. Collectively, the treatment of most of EOC include surgical cytoreduction followed by adjuvant systemic platinum-based chemotherapy. The most common chemotherapy and route of administration for systemic treatment is paclitaxel plus carboplatin given intravenously. However, the treatment of EOC has been rapidly evolving and emerging targeted therapies such as poly (adenosine diphosphate-ribose) polymerase inhibitors, immune checkpoint inhibitors, and antiangiogenic agents are also available. On the other hand, non-EOC responds well to combination chemotherapy used to treat testicular cancer (bleomycin, etoposide, cisplatin) and has a good prognosis. Frontline chemotherapeutic regimen selection differs according to histological subtype, molecular alterations, and patient characteristics. Here, we review specific characteristics of non-serous and non-EOC emphasizing the peculiarities of systemic therapy for each subtype.

Non-epithelial ovarian carcinoma: what is the optimal staging surgery?

Non-epithelial ovarian neoplasms are a group of infrequent, heterogenous clinical and histological tumors that account from 6% to 10% of ovarian malignancies, the two most common non-epithelial ovarian neoplasms are germ cell tumors and sex cord-stromal cell tumors, each of these classifications is divided in multiple histologic subtypes. In the case of epithelial ovarian tumors comprehensive surgical staging has remained as the gold standard for staging, nonetheless for non-epithelial ovarian neoplasms the use of staging surgery has remained debatable and controversial throughout the years in order to correctly stage non-epithelial ovarian carcinomas. Despite the fact that the role of surgery remains critical in the adequate management of all ovarian tumors, there are several manners to surgically approach an ovarian tumor depending on the type of tumor, risk factors and staging of disease. There are multiple reasons why the use of surgery in non-epithelial ovarian tumors is still debatable nowadays, for instance the main reason relies in the low prevalence of this disease, therefore there are few studies that actually offer a clear and sufficient overview to this issue. The objective of this manuscript is to present a comprehensive review of the non-epithelial carcinoma and to focus in the latest information, evidence and recommendations about the optimal treatment and staging surgery for these tumors.

MRI of a Sertoli Cell Tumor of the Testis: A Case Report

Introduction: Sertoli cell tumors (SCTs) of the testis are relatively rare neoplasms that originate from the sex cord and interstitial stromal cells of the testis. Magnetic resonance imaging (MRI) can be used for characterization, particularly recommended when clinical and ultrasonography (US) features are indeterminate for the staging of local lesions. Scrotal MRI may also help in the imaging-based differential diagnosis of a wide range of testicular neoplasms and prevents unessential radical orchiectomy in cases of benign lesions. Accurate and early diagnosis will play a key role in keeping the viability of testicle and fertility. Case Presentation: We present the case of a 46-year-old male with a 1-year duration of a left painless testicular tumor that has had some recent enlargement. He has been admitted to the Department of Urological Surgery, Shenzhen Bao’an people’s hospital, Shenzhen, Guangdong Province, China, on Dec 2nd, 2018. Laboratory tests were within normal limits. A well-defined margin (pseudocapsule) can be found both on US and pre-contrast MRI, but organ-sparing surgery is not advocated for the suspicious malignant features, including recent enlargement, intratumoral hemorrhageand necrosis, and contrast-enhancing solid tissue with indistinct and irregular marginss on MRI. Finally, this patient proceeded with radical orchiectomy after a sufficient preoperative assessment. Conclusions: The low incidence rate of SCTs and their similar clinical features to those of other testicular tumors make their preoperative diagnosis challenging, but the identification of the tumor’s extent, morphologic information, signal component, adjacent relationship, and distant metastasis on MRI images can be vital to make a differential diagnosis, establish reasonable intervention plans, and predict the prognosis.