Delayed Recognition of Disorders of Sex Development (DSD): A Missed Opportunity for Early Diagnosis of Malignant Germ Cell Tumors

Figure 3

Immunohistochemical staining of the carcinoma in situ lesion of patient 3 at three and twelve years of age. (a) Representative hematoxylin and eosin staining. Positive staining for (b) OCT3/4 (brown), (c) TSPY (red) of the germ cells present in the CIS. (a–c) Biopsy tissue at 3 years of age. (d) Representative hematoxylin and eosin staining. Positive staining for (e) OCT3/4 (brown), (f) TSPY (red), and (g) SCF (brown) of the CIS cells. (d–g) Gonadal tissue at 12 years of age. (e–g) Region indicated with a square in (d) is shown. Note the expression of OCT3/4, TSPY, and SCF in the CIS cell indicated by the arrow. Magnification 200x and 400x for all. Slides (b)–(g) are counterstained with hematoxylin. (h) Timeline showing the clinical history, histology, and actions taken.