Aristi-Urista G, Bezzerri-Colonna M, González-Mena L, Duarte-Torres R, Manzanilla-García H

Idioma: Español
Referencias bibliográficas: 35
Paginas: 24-30
Archivo PDF: 154.10 Kb.

RESUMEN

Presentamos un caso característico de tumor de Sertoli de células grandes calcificante de testículo (TSCGC), no asociado a síndromes genéticos, en un hombre de 25 años de edad. Las neoplasias de células de Sertoli ocupan menos del 1% de todos los tumores testiculares. El TSCGCT es una variante específica que difiere en sus características microscópicas y clínicas; es extremadamente raro y afecta comúnmente a pacientes jóvenes. Puede acompañarse de ginecomastia y/o seudoprecocidad isosexual. La ultraestructura y el inmunofenotipo apoyan la diferenciación de este tumor hacia células de Sertoli. El TSCGC puede presentarse aislado o asociado al complejo de Carney: mixomas cardiacos, cutáneos, en tejidos blandos y mama; máculas centrofaciales, nevo azul, hiperplasia adrenocortical suprarrenal pigmentada, adenomas hipofisarios somatotropos, schwannoma melanótico psamomatoso y otros componentes más raros. Es muy importante que el médico conozca y busque otros componentes del complejo de Carney en cualquier enfermo con TSCGC, sobre todo para prevenir las complicaciones cardiacas y embólicas. Menos frecuentemente, el TSCGCT se asocia con síndrome de Peutz-Jeghers. La mayor parte de los TSCGC se comportan de manera benigna, aunque han sido descritos casos malignos con metástasis múltiples relacionados con tumores de gran tamaño, extensión extratesticular, necrosis y atipia citológica. El tratamiento puede variar según se trate de la forma aislada o sindromática.

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