PMC8022032_01
PMC8022032_02
Growth chart of the patient according to the cross-sectional growth chart for
Japanese girls. Growth acceleration began
at 8 yr of age.
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SD for normal Japanese girl), respectively. She had been experiencing growth acceleration for the preceding 9 mo (Fig. 1). Skeletal maturity estimated from left hand and wrist radiographs, using the Tanner-Whitehouse 2 method for Japanese populations, was 8 yr and 9 mo.
Ultrasonographic imaging of the right gonad. (A) Age: 8 yr and 9 mo. Heterogeneous
solid mass (2.74 x 1.64 x 3.09 cm) including small cystic components. (B) Age: 10 yr.
The mass had enlarged (2.70 x 3.03 x 4.33 cm) during the 15 mo.
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Ultrasonographic (US) imaging of the abdomen and inguinal regions demonstrated the absence of ovaries and Mullerian structures, presence of a testis-consistent mass (1.34 x 1.33 x 2.59 cm) in the left inguinal area and presence of a solid mass (2.74 x 1.64 x 3.09 cm) with small cystic components in the right intra-abdominal area, suggestive of a dysgenetic testis (Fig. 2A). During this interval, serum LH and FSH levels remained below 0.1 mIU/mL, and estradiol levels increased to remarkably high levels (218.6-338.8 pg/mL) (Table 2), concomitant with enlargement of the right intra-abdominal mass (2.70 x 3.03 x 4.33 cm) (Fig. 2B).
(A), (B) Gross appearance of the excised right gonad containing a solid tumor. (C)
Photomicrograph of a hematoxylin and eosin stained tumor section. The tumor was
composed of tubules consisting of enlarged Sertoli cells. (D) Tumor cell
immunohistochemistry demonstrating the presence of inhibin.
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Grossly, the excised right gonad demonstrated a solid tumor with a smooth capsule, and the cut surface was soft and yellow (Figs. 3A and 3B). The tumor was composed of tubules formed by enlarged Sertoli cells with eosinophilic cytoplasm and oval nuclei (Fig. 3C). S-100, c-kit, and octamer-binding transcription factor-3/4 (Oct-3/4) (Fig. 3D). Such findings are consistent with Sertoli cell tumors.
PMC8022032_03