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Myoid gonadal tumor. Case series, systematic review, and Bayesian analysis
Salvatore Lorenzo Renne1,2, Marina Valeri1,2, Antonella Tosoni3
1Department of Pathology, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089, Rozzano, MI, Italy.
Virchows Archiv : an International Journal of Pathology
|November 3, 2020
Summary
Myoid gonadal stromal tumors are rare testicular neoplasms. This study, combining case series and literature review, provides the most comprehensive description to date of these tumors.
Area of Science:
- Oncology
- Pathology
- Genitourinary Neoplasms
Background:
- Myoid gonadal stromal tumors (MGSTs) are rare testicular neoplasms with smooth muscle and gonadal stromal differentiation.
- Limited case reports highlight heterogeneous clinical and pathological features, necessitating further characterization.
Observation:
- This study presents the largest case series (4 cases) of MGSTs with detailed morphologic, immunohistochemical, and molecular analysis.
- A systematic literature review identified 9 additional papers, bringing the total collective cases to 16.
- MGSTs predominantly affect adults (mean age ~40 years), typically present as ~3 cm tumors, and infiltrate testicular tubules.
Findings:
- Tumors are composed of spindle cells with occasional mitoses (2/10 HPF).
- Neoplastic cells exhibit diffuse positivity for α-smooth muscle actin (SMA) with a characteristic tram-track pattern.
- Immunohistochemistry reveals characteristic positivity for S100 protein, FOXL2, and SF1.
- Epithelial differentiation is observed in approximately half of the cases.
Implications:
- Bayesian statistical analysis was employed to integrate diverse data, enabling a more precise description of this rare entity.
- The findings enhance the understanding of MGSTs' morphology, immunophenotype, and potential for epithelial differentiation.
- This study advocates for the application of statistical approaches in pathology for characterizing rare diseases.

