Testicular 'Tumor' of the adrenogenital syndrome: A case report of an unusual association with myelolipoma and seminoma in cryptorchidism

Adekunle Adesokan, Patrick A. Adegboyega, Daniel F. Cowan, Jeffrey Kocurek, Durwood E. Neal

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

BACKGROUND. Males with congenital adrenal hyperplasia may develop bilateral testicular masses in early adult life. These are not malignant and generally regress with corticosteroid therapy. The authors report a case occurring in a 44-year-old man with associated seminoma and myelolipoma in an undescended testis. METHODS. The testicular tumors were analyzed by histologic, flow cytometric, and ultrastructural techniques. RESULTS. The tumors in both testes were comprised of polygonal cells with abundant granular eosinophilic cytoplasm, occasionally with brown (lipochrome) pigment and round nuclei of various sizes with prominent nucleoli. These cells were grouped into nodules by dense and sometimes thick fibrous trabeculae in the right testis. The areas corresponding to the fibrous trabeculae in the left (intraabdominal) testis were replaced by mixture of hematopoietic (myeloid) and fatty tissue in various proportions characteristic of myelolipoma. The left testis also had a well demarcated tumor that was diagnostic of seminoma. Electron microscopy demonstrated abundant smooth endoplasmic reticulum, a moderate number of mitochondria with tubulovesicular cristae, lipid droplets, and lipofuscin granules in the polygonal cells. No Reinke's crystals were observed. The patient received corticosteroids for his adrenocorticoid deficiency and also underwent external beam irradiation to the retroperitoneum for seminoma. CONCLUSIONS. This case illustrates an unusual presentation of a testicular tumor in a patient with the adrenogenital syndrome as well as with myelolipoma and seminoma in a cryptorchid testis. The possibility of an associated neoplasm that could be potentially fatal should be considered whenever a testicular tumor of the adrenogenital syndrome continues to grow despite adequate hormonal treatment.

Original languageEnglish (US)
Pages (from-to)2120-2127
Number of pages8
JournalCancer
Volume80
Issue number11
DOIs
StatePublished - Dec 1 1997
Externally publishedYes

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Keywords

  • Adrenogenital syndrome
  • Myelolipoma
  • Seminoma
  • Testicular tumor
  • Undescended testis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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