Histopathologu zyxwvutsrqponml 1995, 26, 255-259 Large cell calcifying Sertoli cell tumour of the testis zy C.PLATA, F zyxwvutsr . ALGABAT, M.ANDUJAR, M.NISTAL$, P .STOCKS§, J.L.MART~NEZ* t+. F. F .NOGALES zyxwvutsr Departments of Pathology, and *Urology, University Hospital, Granada, tDepartments of Pathology, Fundacion Puigvert, Barcelona, and zyxwvutsrqpo $La Paz Hospital, Madrid, Spain; and §King's Mill Hospital, Sutton-in-Ashjleld, UK Date of submission 8 September 1 9 9 4 Accepted for publication 6 November 1994 PLATA C., ALGABA F.. ANDfJJAR M., NISTAL M.. STOCKS P., MARTfNEZ J.L. & NOGALES F.F. (1995) Histopathology 26, 255-259 Large cell calcifying Sertoli cell tumour of the testis Five cases of large cell calcifying Sertoli cell tumour of the testis not associated with complex dysplastic syndromes are reported. The age of the patients ranged from 13 to 34 years and all the tumours were histologically similar, having large, isomorphic, non-mitotic, eosinophilic Sertoli cells with foci of calcification. Flow cytometry demonstrated the cells to be diploid or hypodiploid. All cases were positive for vimentin and focally positive for low molecular weight keratin. The present cases, together with a review of the 22 previously reported tumours, demonstrate that there are two clear cut types of large cell calcifying Sertoli cell tumour; those which are associated with complex dysplastic syndromes and which are bilateral and multifocal, and those which are not associated and are unilateral and focal. Prognosis in all of our cases was uniformly good despite invasion of the rete testis in two cases. It is considered that conservative resection of the tumour is the treatment of choice in cases not associated with complex dysplastic syndromes, since the malignancy rate is low. Keywords: testis, Sertoli cell tumour, calcification, complex dysplastic syndromes Introduction Large cell calcifying Sertoli cell tumour of the testis is a rare variety of testicular tumour'. To date, only 22 cases have been reported in the literature. The tumour may be associated with complex dysplastic syndromes. Furthermore, it is frequently bilateral and multifocality may present problems in the correct choice of treatment. Here we report the clinico- pathological and immunohistochemicalfeatures of five cases of the tumour. Materials and methods Five cases of large cell calcifying Sertoli cell tumour were studied. The number of blocks ranged from six (case 1) to one (case 3). Immunohistochemistry with avidin-biotin technique using the following antibodies was performed: monoclonal vimentin (Dakopatts, Address for correspondence: Professor F.F.Nogales,Departamento de Anatomia Patologica. Facultad de Medicina, Avenida de Madrid, 18012 Granada, Spain Denmark), keratins 8, 18, 19 (Biodesign, Kennebunk- port ME) and CAM 5.2 (Beckton Dickinson, San JosC CA), polyclonal P-hCG, alpha-1-antichymotrypsin and alpha fetoprotein (Dakopatts, Denmark), and laminin (Biogenex, San Ramon CA). Paraffin-embedded tissue was processed for flow cytometry analysis according to the technique described by Hedley et ~ 1.~. Results CASE HISTORIES Case 1. A 13-year-old boy noticed a hard nodule in his right testis following minor trauma. He was examined 6 months later and found to have a l c m nodule in the upper pole of the right testis which ultrasonography showed to be a highly echoic intraparenchymatous area (Figure 1). The contralateral testis appeared normal. A diagnosis of calcified haematoma was made and resection was carried out. Two weeks after the histopathological diagnosis the patient underwent right orchidectomy but no tumour was found in the 255