We present a unique case of bilateral gonadoblastoma in a 23-year-old patient with Swyer syndrome. The gonadoblastoma on both sides underwent synchronous neoplastic transformation, into a stage I germinoma in the right streak gonad and a highly differentiated Sertoli cell tumor in the left one. The latter was associated with a myriad of microscopic, Sertoli cell implants on the peritoneal surface, which were considered benign as they had a high grade of differentiation, minimal proliferative activity, and an absence of invasion. Most probably, the pathogenesis of this abdominal dissemination was iatrogenic, with implantation occurring mechanically as a result of the multiple laparoscopic biopsies performed on both of the streak gonads 2 months before the abdominal surgery. The pathogenesis of other benign abdominal implants is discussed.
Department of Pathology and Obstetrics and Gynecology (G.A.O., L.B., S.D., P.C-R.), Università degli Studi di Sassari, Sardinia, Italy
Department of Pathology and Obstetrics and Gynecology (A.N., O.P., J.A-F., F.F.N.), Facultad de Medicina, Granada, Spain
Address correspondence and reprint requests to Francisco F. Nogales, MD, PhD, Department of Pathology, Facultad de Medicina, Av Madrid 11, 18012 Granada, Spain. e-mail: firstname.lastname@example.org