| Entity/subtype | Typical age | Frequency/rarity stats | Key clinical/endocrine features | Key diagnostic IHC markers | Key molecular/genetic associations | Typical management | Prognosis/outcome stats | Key sources (citation IDs) |
|---|---|---|---|---|---|---|---|---|
| Leydig cell tumor | Mostly adults 20–60 years; ~20% in children | ~1% of all testicular tumors; most common SCST; bilateral in ~3%; benign in ~80–90%, malignant in 10–20% | Adults: gynecomastia, testicular atrophy, decreased libido, erectile dysfunction, prostate atrophy; due to estradiol/progesterone/testosterone production. Children: precocious puberty, gynecomastia. Tumor markers usually normal; US typically hypoechoic; MRI useful | Reinke crystals on histology; table in review lists inhibin+, SF1+, MelanA+ for Leydig cell tumor | Sporadic FH mutation association reported with RCC; beta-catenin alterations reported in some Leydig tumors | Inguinal orchiectomy standard; testis-sparing surgery (TSS) for peripheral/small lesions; low sensitivity to chemo/radiotherapy | Malignant LCT 5-year survival ~91% | (pqac-00000008, pqac-00000009, pqac-00000001, pqac-00000006) |
| Sertoli cell tumor (classic) | Not clearly specified in provided context; generally adult | <1% of all testicular tumors; second most common SCST after Leydig; usually benign and unilateral | Tumor markers usually normal; slight AFP elevation reported in some cases | WHO-recognized classic SCT; beta-catenin nuclear staining can be diagnostically useful in many Sertoli-pattern tumors | Large percentage show CTNNB1 mutation with nuclear β-catenin staining | Inguinal orchiectomy if malignancy suspected | Malignant stage I Sertoli tumor 5-year survival ~77%; RPLND recommended even for stage I malignant disease in cited review | (pqac-00000009, pqac-00000002, pqac-00000006) |
| Large cell calcifying Sertoli cell tumor | Not clearly specified; can occur in syndromic settings | ~90 cases reported in literature; 16 malignant; ~17% may show malignancy/local invasion | Usually palpable hard painless testicular mass; often unilateral/single; may show skin involvement; US with calcifications and central vascularity; tumor markers may be normal | Alpha-inhibin positive in ~90%; also pan-cytokeratin, EMA, S100, desmin, vimentin, NSE, chromogranin positive; OCT4, CD10, CD99, Melan-A negative; PRKAR1A IHC may aid diagnosis | Associated with Carney complex; large cell calcifying SCT included among sporadic tumors and genetic syndromes; PRKAR1A diagnostically useful | Radical inguinal orchiectomy if suspected; RPLND if retroperitoneal nodes involved; TSS may be considered for superficial/peripheral/small/bilateral tumors given predominantly benign behavior | Predominantly benign; malignancy defined by adverse histologic criteria such as size >4 cm, vascular invasion, atypia, necrosis, increased mitoses | (pqac-00000009, pqac-00000014, pqac-00000013) |
| Adult-type granulosa cell tumor | Average onset ~42 years; oldest reported 87 years | Extremely rare; 73 cases reported in review; usually large (10–14 cm) and unilateral | Gynecomastia in ~50%; often large masses with possible cystic components; microscopic “coffee-bean nuclei” | Inhibin A positive; in case report: inhibin+, vimentin+, CD117-, CD30-, CK/CK8-, EMA-, PLAP-, S100- | Associated with FOXL2 mutation; testicular frequency lower than ovarian counterpart; one sequenced case had FOXL2 C134W plus CDKN2A, TP53, TERT promoter, H3F3A mutations; recent work suggests testicular AGCTs differ molecularly from ovarian tumors | Inguinal orchiectomy is gold standard; TSS considered for atrophic/single testis; one case used adjuvant BEP after orchiectomy | Potential for late recurrence/metastasis; case report disease-free at 6 years after orchiectomy + BEP | (pqac-00000010, pqac-00000011, pqac-00000015) |
| Juvenile granulosa cell tumor | Primarily infants up to 6 months; rarely adults | Extremely rare | Usually painless testicular mass; often firm/cystic; associated with cryptorchidism or karyotypic abnormalities; AFP remains normal; lacks adult-type “coffee-bean nuclei” | Inhibin alpha positive like other SCSTs | Potential link to chromosomal abnormalities/aberrant gonadal development noted in review of testicular GCTs | TSS considered sufficient | No malignant cases reported in the cited literature; benign behavior | (pqac-00000009, pqac-00000010, pqac-00000015) |
| Signet ring stromal tumor | Not clearly specified in provided context | Exceptionally rare; testicular tumors usually 0.5–2.8 cm (average 0.9 cm) | Usually solitary, unilateral; no recurrences reported | Positive mainly for beta-keratin and vimentin; occasional CD99; resembles Sertoli tumor immunophenotypically; lacks Reinke crystals | Added as new WHO 5th edition entity; debate whether within Sertoli spectrum because of shared β-catenin profile | No official recommendations due to rarity; TSS appears appropriate | Reported as always benign in experts’ view; no malignant cases or recurrences reported | (pqac-00000010, pqac-00000014, pqac-00000012) |
| Myoid gonadal stromal tumor | Adult men, around 40 years | Rare; usually ≤3 cm; largest reported 4.3 cm | Tumor markers usually normal; recent literature suggests benign behavior | Positive for FOXL2, S100, SF1, inhibin | New WHO 5th edition entity; listed separately because morphologically/IHC distinct from other sex-cord tumors | Not standardized; conservative/testis-sparing approach often favored for presumed benign lesions | Appears benign in available literature | (pqac-00000010, pqac-00000001, pqac-00000014) |
| SCST-NOS / mixed sex cord-stromal tumor | Not clearly specified in provided context | Rare; SCST-NOS reserved for undifferentiated/immature cells that cannot be precisely subtyped | Mixed tumors may present as gelatinous testicular masses; tumor markers usually normal; may show cystic/hemorrhagic areas; histology can include spindle, Sertoli, and granulosa-like elements | No single defining panel provided in context; diagnosis relies on mixed/undifferentiated morphology; SCST-NOS used when precise subtype not possible | WHO 2022 separates mixed SCSTs from SCST-NOS; mixed tumors contain variable sex-cord/stromal elements | Orchiectomy often performed because of diagnostic uncertainty; TSS may be considered if benign features suspected | SCSTs usually indolent overall, but metastases can occur even in morphologically typical tumors; advanced SCSTs have poor outcomes compared with GCTs | (pqac-00000012, pqac-00000010, pqac-00000020) |


*Table: This table summarizes the major recognized subtypes of testicular sex cord-stromal tumors using only the provided context. It compares rarity, phenotype, diagnostic markers, molecular associations, management, and outcome data to support disease knowledge-base curation.*