Editors: Francesca Khani  ( and Mahmut Akgul (

2021-52/December 27
Contributors: Mehdi Mansoor and Farshid Siadat

A man in his mid-40s presented with a right testis mass. Serum LDH was 243 U/L (normal: 100-235 U/L). β-HCG and α-FP were in the normal range.  A right radical orchiectomy was performed.


What is the correct diagnosis?

a. Seminoma

b. Sclerosing Sertoli cell tumor

c. Metastatic clear cell carcinoma

d. Adenomatoid tumor

e. Adult granulosa cell tumor

Sclerosing Sertoli cell tumor

Sclerosing Sertoli cell tumor is a rare entity among sex cord-stromal tumors of testis. Morphologically, the tumor is well circumscribed and firm with a tan-white color. Histologic examination shows Sertoli cells forming small nests, cords and tubules, or they are arranged in an irregular pattern. The cytotomorphology of the cells show clear cytoplasm and round to ovoid small nuclei with occasional small to moderate size nucleoli. At least 50% of the lesion consists of a dense, fibrotic and hyalinized hypocellular stroma. Positive immunohistochemical markers include cytokeratins (AE1/AE3 or pancytokeratin), β-catenin (nuclear pattern of staining), WT1, inhibin, calretinin, S100 and neuroendocrine markers. The lesion is negative for germ cell markers including OCT4, EMA, AMACR and CD117.

The clinical course of the disease is indolent, and simple orchiectomy is usually sufficient for treatment.

In our case, immunohistochemistry showed positivity for nuclear β-catenin, cytokeratin, CD56, and WT1. There was only focal staining for inhibin and lack of staining for germ cell markers, calretinin, synaptophysin and chromogranin. Overall, the morphologic and immunohistochemical stains supported a sclerosing Sertoli tumor of the testis.

1.Moch H, Humphrey P, Ulbricht T, Reuter V. WHO Classification of Tumours of the Urinary System and Male Genital Organs.4th ed. Lyon, France: IARC Press; 2016.

2. Kao C, Kum J, Idrees M, Ulbright T. Sclerosing Sertoli Cell Tumor of the Terstis: A Clinicopathologic Study of 20 Cases

Mehdi Mansoor and Farshid Siadat
Department of Pathology and Laboratory Medicine, University of Calgary and Alberta Precision Laboratories
Rockyview General Hospital, 7007 14 Street, Calgary, AB T2V 1P9, Canada,


Sclerosing Sertoli cell tumor, Sex cord-stromal tumor, testis