More recently, in a Polish study conducted in a 180 GCT patient cohort,a correlation among 1) lower expression of immune checkpoint proteins V-domain Ig suppressor of T cell activation (VISTA) and PD-L1 on TME, 2) elevated inflammatory marker platelet-to-lymphocyte ratio and 3) higher risk of events was reported, suggesting an involvement of both local and systemic anti-tumor immune response in GCTs (59). This evidence concerns the gene CD274 and granular cell tumor.