Abstract
Introduction: Sertoli cell tumors (SCTs) of the testis are relatively rare neoplasms that originate from the sex cord and interstitial stromal cells of the testis. Magnetic resonance imaging (MRI) can be used for characterization, particularly recommended when clinical and ultrasonography (US) features are indeterminate for the staging of local lesions. Scrotal MRI may also help in the imaging-based differential diagnosis of a wide range of testicular neoplasms and prevents unessential radical orchiectomy in cases of benign lesions. Accurate and early diagnosis will play a key role in keeping the viability of testicle and fertility. Case Presentation: We present the case of a 46-year-old male with a 1-year duration of a left painless testicular tumor that has had some recent enlargement. He has been admitted to the Department of Urological Surgery, Shenzhen Bao’an people’s hospital, Shenzhen, Guangdong Province, China, on Dec 2nd, 2018. Laboratory tests were within normal limits. A well-defined margin (pseudocapsule) can be found both on US and pre-contrast MRI, but organ-sparing surgery is not advocated for the suspicious malignant features, including recent enlargement, intratumoral hemorrhageand necrosis, and contrast-enhancing solid tissue with indistinct and irregular marginss on MRI. Finally, this patient proceeded with radical orchiectomy after a sufficient preoperative assessment. Conclusions: The low incidence rate of SCTs and their similar clinical features to those of other testicular tumors make their preoperative diagnosis challenging, but the identification of the tumor’s extent, morphologic information, signal component, adjacent relationship, and distant metastasis on MRI images can be vital to make a differential diagnosis, establish reasonable intervention plans, and predict the prognosis.