Gonadoblastoma.A review of 74 cases

A clinicopathologic analysis revealed the gonadoblastoma to be composed of germ cells and immature cells of Sertoli or granulosa type; cells resembling Leydig and lutein cells were usually present as well. Calcification was common, occasionally appearing on roentgenograms of the pelvis. All the patients were sexually abnormal. The gonad bearing the tumor was generally of indeterminate nature but was sometimes identifiable as a streak or a dysgenetic cryptorchid. Four fifths of the patients were phenotypic females, who were commonly virilized, while the remainder were phenotypic males, who almost always had cryptorchidism, hypospadias, and female internal secondary sex organs. Eighty-nine percent of the patients were chromatin-negative, and the most common karyotypes were 46,XY and 45,X/46,XY. There was strong evidence of androgen production by some tumors. The gonadoblastoma may be regarded as an in-situ cancer from which germinomas and occasionally other types of invasive germ-cell tumor can develop.