We report a study of seven men, aged 16 to 76 years (average age, 47.4 years) with
granulosa cell tumor (GCT) of the testis. Three patients presented with testicular
enlargement of several years' duration and a fourth presented with a testicular enlargement
of unknown duration. The tumors in three patients were detected during routine physical
examination. None of the patients had endocrine-related symptoms. All tumors were
well circumscribed and showed the solid, cystic, microfollicular, gyriform, insular,
and trabecular patterns typical of GCT of the ovary. Call-Exner bodies were present
in three tumors and two tumors had a focal spindle-cell component. In one case the
surrounding testicular parenchyma showed Leydig's cell hyperplasia and a Sertoli cell
nodule. The tumor cells revealed strong immunoreactivity for vimentin but showed no
expression for keratin or epithelial membrane antigen. One patient developed liver
and retroperitoneal lymph node metastases 121 months after initial diagnosis and died
13 months later. Another patient initially presented with retroperitoneal lymph node
metastasis and developed metastasis to the inguinal lymph nodes 12 months later. Three
patients are alive at 1, 4, and 37 months with no evidence of disease. Another patient
died of an unrelated condition. Follow-up information was not available for the seventh
patient. Twelve cases of GCT of the adult testis have been reported in the literature,
with metastases occurring in two: one of these two patients had a tumor for 8 years
and died of disease 5 months after diagnosis with multiple metastases and the other
had metastasis at the time of diagnosis, but was free of disease for 14 years. Our
findings and a review of the literature indicate that GCT of the adult testis is a
rare and slow-growing neoplasm with the potential to form distant metastases. Because
recurrence or distant metastasis may occur late in the clinical course, long-term
follow-up of these patients is recommended.