Large cell calcifying Sertoli cell tumor of the testis: Case report with ultrastructural study

Large cell calcifying Sertoli cell tumor (LCCST) is a rare testicular tumor, usually occurring in young men before the age of 20. Ultrastructural study has been performed rarely demonstrating Sertoli cell features. We report a case of LCCST in a 7-year-old boy. A well-circumscribed yellowish- tan, 1.5-cm-sized mass was located within the left testicular parenchyma. The cut surface was somewhat resilient with multiple calcifications. On microscopic examination, the tumor was composed of large eosinophilic polygonal cells with abundant eosinophilic cytoplasm arranging in solid tubular and trabecular patterns, superficially mimicking Leydig cell tumor. However, there were multiple calcifications and the tumor cell nests were surrounded by PAS-positive basement membrane. Ultrastructural examination revealed the features of the Sertoli cell with Spangaro's crystals. The right testis showed a normal appearance by ultrasonogram and there were no other clinical features associated with Carney syndrome.