Systemic Treatment of Metastatic Sertoli Cell Tumor

TL;DR

A 52-year-old man with metastatic Sertoli cell tumor showed aggressive disease despite combined chemotherapy and hormonal treatment.

Contribution

This case highlights the challenges in managing rare, hormone-producing, treatment-refractory testicular neoplasms.

Findings

The patient had metastases to the pleura, liver, and bones with elevated estradiol and testosterone levels.

Combined BEP chemotherapy and hormonal therapy failed to halt disease progression.

The case underscores the aggressive nature and poor prognosis of metastatic Sertoli cell tumors.

Abstract

We report the case of a 52-year-old man with a metastatic right testicular Sertoli cell tumor. The patient presented with fatigue, anorexia, unintentional weight loss, and bilateral gynecomastia. Staging computed tomography revealed pleural, hepatic, and bone metastases. Laboratory evaluation demonstrated markedly elevated estradiol and testosterone levels with suppressed gonadotropins. Histopathological analysis of a metastatic soft-tissue lesion confirmed the diagnosis. A multidisciplinary approach combining BEP (bleomycin, etoposide, and cisplatin) chemotherapy with hormonal therapy using letrozole and goserelin was initiated. Despite treatment, disease progression was observed, and enrollment in a clinical trial was considered. The patient ultimately died one month later due to respiratory failure. This case highlights the aggressive behavior of metastatic Sertoli cell tumors and underscores the challenges in managing rare, hormone-producing, treatment-refractory testicular neoplasms.

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