DOCSLIB.ORG

ADENOMATOID TUMOR of the SPERMATIC CORD Department Of

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
ADENOMATOID TUMOR of the SPERMATIC CORD Department Of THE KURUME MEDICAL JOURNAL Vol. 27, P.97-100, 1950 ADENOMATOID TUMOR OF THE SPERMATIC CORD NOBUYUKI MIYOSHI, SHINSHI NODA, KOUSAKU ETO AND MASAHI O ARAKAWA Department of Urology, and First Department of Pathology, Kurume University School of Medicine, Kurume, 830, Japan Received for publication March 18, 1980 We have encountered a case of tumor of the spermatic cord, a relatively rare disease. The case is a 60-year old man. Histologic examinations revealed that the tumor was an adenomatoid leiomyoma. The case of adenomatoid tumor hitherto reported in Japan totals 66 inclusive of ours. However, they are reported as primary epididymal tumor in literature. Ours is also a tumor which developed in the epididymal region, but it is most likely to have originated from the tunica vaginalis of the spermatic cord judging from the macroscopic and histologic findings. INTRODUCTION On palpation, the intrascrotal tumor was felt along the spermatic cord in- The tumor of the spermatic cord is dependent of the left testis and epi- a relatively rare disease. Its histologic didymis. classification was made by Prince (1942). It was a mass with a size of the tip The incidence of this disease as intra- of the small finger, the surface of scrotal tumor is the second highest which was smooth. It was elastic and after tumor of the testis and higher hard in consistency, spherical, movable than that of tumor of the epididymis and non-tender. and tunica vaginalis testis. The testis and epididymis on the According to the overseas literature, right and lymph nodes in the inguinal about 70 percent of the cases of tumor region on both sides showed no abnor- of the spermatic cord are benign and mal signes. After admission, various about 30 percent malignant. examinations were conducted, but no We have encountered a case of ade- abnormalities were observed in any nomatoid tumor originating from the aspect physical, biochemical and radi- spermatic cord, the details of which ological. are reported here. As for the past history, he had pulmonary tuberculosis 30 years earlier. Suspected of tumor of the sperma- CASE tic cord from the findings above, ex- tirpation of tumor was performed under A 60-year old man was seen at this local anesthesia. An incision was made hospital with left intrascrotal tumor on the skin of left scrotum under local as the chief complaint on October 19, anesthesia to let contents of the scro- 1978. He noticed the tumor in 1971 but tum come out of the wound. lef it untreated for eight years since The tumor mass was found about 3 it was asymptomatic. cm away from the tail of the epididy- 97 98 MIYOSHI, ET AL. mis and was not communicated directly with the epididymis. The tumor was located along the spermatic duct and it was removed with a part of the spermatic duct. The tumor removed measuring about 1.0 cm •~ 1.2 cm •~ 1.0 cm was almost spherical in shape. The cut surface was grayish white (Fig. 1). Histopathologically, many lumens were formed among the bundles of smooth muscles. On the whole, small Fig. 1. A cut section of adenomatoid vacuoles were conspicuous and partly tumor of cord. lymphatic nodules were also formed. Cells forming the lumens varied in shape from those which were cubic and looked like epithelial cells to others which were flat and resembled endothe- lial cells of the vascular lumen. These cells had no atypia, nor were there any malignat patterns (Figs. 2, 3). DISCUSSION Of the neoplasms in the scrotum other than the testis, tumor of the Fig. 2. Photomicrograph of tumor show- spermatic cord is found the most, and ing bundles of smooth muscle and epithelial- it is originated from various tissues like tubules. (H. E •~ 50). that constitute the spermatic cord, that is, the spermatic duct, blood ves- sels, lymph vessel, connective tissue, adipose tissue, smooth muscle, striated muscle, fascia and nerve tissue. Seventy percent of tumors of the spermatic cord are benign tumors, most of which is accounted for by lipoma. The remaining 30 percent are malig- nant tumors, most of which are sarcoma (Beccia et al., 1976). As for adenomatoid tumor, there have long been much confusion and argument as to the pathology, the origin and classification. Fig. 3. Photomicrograph of tumor show- ing conspicuous infiltration of lymphoid Since Sakaguchi (1917) reported it cells. (H. E •~ 50). as adenomyoma, it has been given various names such as adenomatoid ADENOMATOID TUMOR OF THE SPERMATIC CORD 99 mesothelioma, adenof ibroma, adeno- rian origin have hitherto been proposed. fibromyoma, adenomyoma, angiomatoi At present, the mesonephric origin tumor, f ibroma, lymphadenoma, lymph- and Mullerian origin appear to be sup- angioma, mesothelioma, myoadenof i- ported by various investigators. broma, adenomatoid leiomyoma and Only one clinical case like ours can mixer adenomatoid. hardly provide data enough to discuss Golden and Ash (1945) studied clini- histogenesis of this tumor, so we have cally and pathologically 15 cases of need for further study of the follow- benign tumors which developed in the ing literature of various investigators genital system although their origin (Evans 1943, Lee et al. 1950, Sundarasi- is unknown and which showed a spe- varao 1953, Jackson 1958, Marcus and cific structure histologically, and de- Lynn 1970). signated these tumors as adenomatoid The histology of this tumor is very tumor. Thus, the term adenomatoid characteristic as can be seen in our tumor has been used up to today. case. According to Mostofi and Price After the concept of this tumor had (1973), it consists of two major compo- been established, many reports were nents the epithelium and fibrous published one after another. interstice plus bundles of the smooth Jackson (1958) reported 109 cases ; muscle and chronic inflammatory cells. by region they are broken down to Moreover, not only the components, epididymis 67, tunica vaginalis testis the composition ratio and arrangement 12, fallopian tube 13, uterus 16 and are full of variations, but also the ovary 1. constituent components arevaried. Recently, 188 cases of adenomatoid The epithelium-like cells vary in tumor were reported by Beccia et al. shape from a cubic, low cylindrical or (1976). flat one to one which resembles endo- In Japan, 62 cases of the disease thelium-like cells, and are often ac- have been reported by Ohara et al. companied by various degrees of vacuo- (1979), and 4 additional cases including lization. the present one have appeared in the The nucleus is generally round or literature after 1979. ovoid, located in the center of the cell, Of them, as many as 64 cases are re- and rich in chromatin or shows forma- ported to be primary epididymal tumor. tion of small vacuoles. These cells are Some of these reported cases have arranged like a cord, tubule, adenoma nothing to do with the epididymis but or lymphangioma. are reported as primary epididymal On the other hand, the interstice tumor, which is beyond our understand- shows sparse connective tissue and even ing. dense collagenized tissue in some pla- Two cases of adenomatoid tumor of ces. the spermatic cord, one by Seta et al. The ratio of the interstice to (1970) and the other by us have been epithelium-like cells is varied. Many reported in Japan. tumors have a mass of the smooth Mostof i and Price (1973) have also muscle, and in about 3 percent of the reported four cases of adnomatoid tu- tumors, the smooth muscle is dominat- mor of the spermatic cord. ing. In almost all tumors, lymphocyte- As histogenesis of this tumor, (1) like cells form small nodules mainly endothelial origin, (2) mesothelial ori- around the tumor. gin, (3) mesonephric origin and (4) Millle- Many lumens, especially small ones, 100 MIYOSHI, ET AL. of the glandullar structure between REFERENCES bundles of the smooth muscles and clusters of infiltrating lymphocytes BECCIA,D. J., KRANE, R. J. and OLSSON, C. A. were observed also in our case. (1976). Clinical management of non-testi- cular intrascrotal tumors. J. Urol. 116, Cells that form the lumens varied 476-479. %. in shape from the epitheliumlike one EVANS, N. (1943). Mesothelioma of epididymis to the endothelium-like one, so the and tunica vaginalis. J. Urol. 50, 249-254. case was diagnosed as mixed adenoma- GOLDEN,A. and ASH, J. E. (1945). Adenomatoid toid tumor and leiomyoma (socalled tumor of the genital tract. Am. J. Pathol. adenomatoid leiomyoma). 21, 63-79. Clinically, the incidence is high in JACKSON,J. R. (1958). The histogenesis of the " males, and it develops in the scrotum in adenomatoid" of the genital tract. Cancer. many cases, more than two thirds of 11, 337-350. which have it in the vicinity of the LEE, M. J. Jr., DOKERTY,M. B., THOMPSON,G. J. lower pole of the epididymis. and WAUGH, J. M. (1950). Benign mesothe- liomas (adenomatoid tumors) of genital Anatomically, it is found in the tract. Surd;. Gynecol. Obstet. 91, 221-231. epididymis, testicular tunics and rarely MARCUS, J. B. and LYNN, J. A. (1970). Ultra- spermatic cord in males and uterus, stracture of an adenomatoid tumor, lym- fallopian tubes and rarely ovary and phangioma, hemangioma and mesothelioma. paraovary in females. Cancer, 25, 171-175. On a very rare occasion is it found MOSTOFI, F. K. and PRICE, E. B. (1973). Atlas in the retroperitoneum adjacent and of tumor pathology 2nd. series. Tumors of adrenal gland. the male genital system. Armed Forces Institute of Pathology. Castle House Pub. The age at onset ranges from 1 to London. P, 144-151. 73 years. Those aged 30 to 50 years OHARA,N., MIWA, M., MATUMOTO,T., TAKASE, M account for about 86 percent of all ., TSUCHIYA,A., OOI, T.
Load more

Recommended publications
  • Adenomatoid Tumor of the Skin: Differential Diagnosis of an Umbilical Erythematous Plaque
    Title: Adenomatoid tumor of the skin: differential diagnosis of an umbilical erythematous plaque Keywords: Adenomatoid tumor, skin, umbilicus Short title: Adenomatoid tumor of the skin Authors: Ingrid Ferreira1, Olivier De Lathouwer2, Hugues Fierens3, Anne Theunis1, Josette André1, Nicolas de Saint Aubain3 1Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium. 2Department of Plastic surgery, Centre Hospitalier Interrégional Edith Cavell, Waterloo, Belgium. 3Department of Dermatology, Saint-Jean Hospital, Brussels, Belgium. 4Department of Pathology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium. Acknowledgements: None Corresponding author: Ingrid Ferreira This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/cup.13872 This article is protected by copyright. All rights reserved. Abstract Adenomatoid tumors are benign tumors of mesothelial origin that are usually encountered in the genital tract. Although they have been observed in other organs, the skin appears to be a very rare location with only one case reported in the literature to our knowledge. We report a second case of an adenomatoid tumor, arising in the umbilicus of a 44-year-old woman. The patient presented with an 8 months old erythematous and firm plaque under the umbilicus. A skin biopsy showed numerous microcystic spaces dissecting a fibrous stroma and being lined by flattened to cuboidal cells with focal intraluminal papillary formation. This poorly known diagnosis constitutes a diagnostic pitfall for dermatopathologists and dermatologists, and could be misdiagnosed as other benign or malignant entities.
    [Show full text]
  • Concurrent Hepatic Adenomatoid Tumor and Hepatic Hemangioma: a Case Report
    pISSN 2287-2728 eISSN 2287-285X Case Report http://dx.doi.org/10.3350/cmh.2012.18.2.229 Clinical and Molecular Hepatology 2012;18:229-234 Concurrent hepatic adenomatoid tumor and hepatic hemangioma: a case report Ji-Beom Kim1, Eunsil Yu2, Ju-Hyun Shim1, Gi-Won Song3, Gwang Un Kim1, Young-Joo Jin1, and Ho-Seop Park2 1Department of Internal Medicine, 2Department of Pathology, and 3Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid
    [Show full text]
  • Microrna Dysregulation Interplay with Childhood Abdominal Tumors
    Cancer and Metastasis Reviews (2019) 38:783–811 https://doi.org/10.1007/s10555-019-09829-x MicroRNA dysregulation interplay with childhood abdominal tumors Karina Bezerra Salomão1 & Julia Alejandra Pezuk2 & Graziella Ribeiro de Souza1 & Pablo Chagas1 & Tiago Campos Pereira3 & Elvis Terci Valera1 & María Sol Brassesco3 Published online: 17 December 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Abdominal tumors (AT) in children account for approximately 17% of all pediatric solid tumor cases, and frequently exhibit embryonal histological features that differentiate them from adult cancers. Current molecular approaches have greatly improved the understanding of the distinctive pathology of each tumor type and enabled the characterization of novel tumor biomarkers. As seen in abdominal adult tumors, microRNAs (miRNAs) have been increasingly implicated in either the initiation or progression of childhood cancer. Moreover, besides predicting patient prognosis, they represent valuable diagnostic tools that may also assist the surveillance of tumor behavior and treatment response, as well as the identification of the primary metastatic sites. Thus, the present study was undertaken to compile up- to-date information regarding the role of dysregulated miRNAs in the most common histological variants of AT, including neuroblas- toma, nephroblastoma, hepatoblastoma, hepatocarcinoma, and adrenal tumors. Additionally, the clinical implications of dysregulated miRNAs as potential diagnostic tools or indicators of prognosis were evaluated. Keywords miRNA . Neuroblastoma . Nephroblastoma . Hepatoblastoma . Hepatocarcinoma . Adrenal tumors 1 MicroRNA biogenesis and function retaining the hairpin (pre-miRNA, ~ 70 nucleotides long), which is translocated by Exportin-5 to the cytoplasm, and then Fundamentally, all cellular programs are controlled by genes: processed by another endoribonuclease (Dicer) into the growth, senescence, division, metabolism, stemness, mobility, miRNA duplex.
    [Show full text]
  • Adenomatoid Tumour of the Adrenal Gland: a Case Report and Literature Review
    CORE Metadata, citation and similar papers at core.ac.uk Provided by Jagiellonian Univeristy Repository POL J PATHOL 2010; 2: 97–102 ADENOMATOID TUMOUR OF THE ADRENAL GLAND: A CASE REPORT AND LITERATURE REVIEW MAGDALENA BIAŁAS1, WOJCIECH SZCZEPAŃSKI1, JOANNA SZPOR1, KRZYSZTOF OKOŃ1, MARTA KOSTECKA-MATYJA2, ALICJA HUBALEWSKA-DYDEJCZYK2, ROMANA TOMASZEWSKA1 1Chair and Department of Pathomorphology, Jagiellonian University Medical College, Kraków 2Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków Adenomatoid tumour (AT) is a rare, benign neoplasm of mesothelial origin, which usually occurs in the genital tract of both sexes. Occasionally these tumours are found in extra genital locations such as heart, pancreas, skin, pleura, omentum, lymph nodes, retroperitoneum, intestinal mesentery and adrenal gland. Histologically ATs show a mixture of solid and cystic patterns usually with focal presence of signet-ring like cells and scattered lymphoid infiltration. The most important thing about these tumours is not to misdiagnose them as primary malignant or metastatic neoplasms. We present a case of an adrenal AT in a 29-year-old asymptomatic male. The tumour was an incidental finding during abdominal CT-scan for an unrelated condition. We also present a review of the literature concerning adrenal gland AT and give possible differential diagnosis. Key words: adenomatoid tumour, adrenal gland, immunophenotype. Introduction histopathological examination. Additional sections were made for immunohistochemical analysis (for Adenomatoid tumour (AT) is a benign neoplasm details see Table I). of mesothelial origin [1-3]. The usual place of its Proliferative activity of the tumour was deter- appearance is the male and female genital tract, most mined using immunohistochemical staining for often epididymis in men and fallopian tube in women nuclear protein MIB-1 (Ki-67).
    [Show full text]
  • Adenomatoid Tumor of the Pancreas
    Adenomatoid Tumor of the Pancreas: A Case Report with Comparison of Histology and Aspiration Cytology Kerith Overstreet, M.D., Chris Wixom, M.D., Ahmed Shabaik, M.D., Michael Bouvet, M.D., Brian Herndier, M.D., Ph.D. Departments of Pathology (KO, CW, AS, BH) and Surgery (MB), University of California, San Diego Medical Center, San Diego, California ovarian hilum (2). Sporadic case reports have also We present a 58-year-old woman who presented noted adenomatoid tumors in such varied ex- with a 1.5-cm, hypodense lesion in the head of the tragenital locations as the adrenal gland (4, 5), small pancreas. Endoscopic ultrasound-guided fine- intestines, omentum, retroperitoneum, bladder, needle aspiration yielded bland, monotonous cells and pleura (3–5). To date, both ultrastructural and with wispy cytoplasm, slightly granular chromatin, immunohistochemical evidence have demon- and small nucleoli. A presumptive diagnosis of a strated this tumor’s mesothelial origin (2, 3, 5). In neuroendocrine lesion was rendered. Whipple pro- this context, we present an adenomatoid tumor of cedure yielded a well-circumscribed, encapsulated the pancreas. To our knowledge, this is the first lesion with dense, hyalinized stroma and a periph- reported case in this location. Herein we report eral rim of lymphocytes. Spindled and epithelioid both cytological and histochemical results docu- cells formed short tubules, cords, and nests. The menting this benign neoplasm in an unusual neoplasm stained for CK 5/6, calretinin, vimentin, location. CD 99, pancytokeratin, and EMA, consistent with mesothelial origin. This characteristic histology and immunohistochemistry is consistent with an ad- CASE REPORT enomatoid tumor. We believe we are the first to A 58-year-old woman with a history of hyperten- report this benign neoplasm in such an unusual sion, cholecystitis, and arthritis presented with a location.
    [Show full text]
  • Unusual Cases in Genitourinary Pathology
    Unusual and Challenging Cases in Genitourinary Pathology Daniel Albertson MD Associate Professor University of Utah Department of Anatomic Pathology I have no conflict(s) of interest to disclose Case #1: 26 year old male with rapidly growing left paratesticular mass measuring 3.5 cm Gross Examination: 3.5 cm round firm mass with yellow center MORPHOLOGY AND IHC PROFILE • Well Circumscribed and Non Encapsulated • Minimal Invasion Into Surrounding Tissue • Peripheral Lymphoid Aggregates • Nests and Cords • Round Nuclei and Abundant Pink Cytoplasm • Central Necrosis . WT-1 + . CK7 + . CK5 + . CK20, HMB-45, GATA-3, SMA, INHIBIN – DIAGNOSIS: INFARCTED ADENOMATOID TUMOR Differential Diagnosis: • Mesothelioma • Typically a gross papillary appearance with tumor studding of tunica • Microscopically infiltrative border and lack of circumscription and typically lacks adenomatoid-like vacuoles • Mitoses more common • Leiomyoma/Leiomyosarcoma • Vascular Lesions (Epithelioid Hemangioendothelioma/Angiosarcoma) • Sex Cord Stromal Tumors • Adenocarcinoma • Epididymitis Skinnider, B. F. and R. H. Young (2004). Infarcted adenomatoid tumor: a report of five cases of a facet of a benign neoplasm that may cause diagnostic difficulty. Am J Surg Pathol 28(1): 77-83. CASE #2: 46 YEAR OLD MALE WITH LONGSTANDING HISTORY OF RIGHT TESTICULAR GROWTH IMAGING FINDINGS: SCROTAL ULTRASOUND DEMONSTRATED A 4 X 2.4 CM HETEROGENOUS HYPERECHOIC MASS ARISING FROM THE RIGHT POSTERIOR-INFERIOR SCROTAL WALL. CD34 MORPHOLOGY AND IHC PROFILE • Somewhat delineated lesion with bland spindle cells, mature adipocytes, and occasional uni- and mutivacuolated lipoblasts • Collagenous to myxoid extracellular matrix • Mild cytologic atypia with nuclear hyperchromasia • No obvious mitoses • No necrosis • CD34 (+) • CD10, DESMIN, SMA (-) • Negative for MDM2 Amplification (NORMAL) • MDM2/CEP12 Ratio: 1.0 • Average MDM2 Signal Number per Cell: 1.8 DIAGNOSIS: ATYPICAL SPINDLE CELL LIPOMATOUS NEOPLASM Clincial Behavior: Most cured by surgery but 10-15% may recur locally.
    [Show full text]
  • Testicular and Paratesticular Tumors Study Questions Sarah M
    Testicular and Paratesticular Tumors Study Questions Sarah M. Kelting, M.D.; Stacey E. Mills, M.D These questions correspond to the glass slide study set available in the Anatomic Pathology resident library. While photomicrographs are provided here with each question, we strongly recommend review of the glass slides in order to fully benefit from each case. Thank you to Jacob S. Grange, M.D. for his contribution of many of the accompanying photomicrographs. 1. S13-1687 A 40-year-old man presents with a testicular mass. What is the expected immunohistochemical profile of this lesion? A. SALL4 +, PLAP +, OCT3/4 +, CD117 -, CD30 +, AE1/AE3 + B. SALL4 +, PLAP +, OCT3/4 +, CD117 +, CD30 - C. SALL4 -, PLAP -, OCT3/4 -, CD117 -, CD30 -, inhibin + D. SALL4 +, PLAP +, OCT3/4 -, CD117 -, CD30-, AFP +, AE1/AE3 + E. SALL4 -, PLAP -, OCT3/4 -, CD117 -, CD30+, EMA + 2. CO16-2576 An 84-year-old man presents with a 4 cm testicular mass. On histologic examination, your differential diagnosis includes seminoma and spermatocytic tumor. In considering the differences between these two tumors, which feature would favor that this represents spermatocytic tumor? A. Negative staining for CD117 B. Presence of intratubular germ cell neoplasia (IGCN) C. Prominent associated granuloma formation D. Presence of three cell types E. Positive staining for OCT3/4 3. S05-28333 This is a testicular tumor from a 28-year-old man. Histologic examination demonstrates a mixed germ cell tumor (GCT). Adjacent to the primary tumor, the presumptive precursor lesion is seen (photomicrograph). Which of the following statements about testicular GCT precursor lesions is false? A. Most adult germ cell tumors are thought to be derived from intratubular germ cell neoplasia, unclassified type (IGCNU), the invasive derivative of which appears to be seminoma.
    [Show full text]
  • Case Report Cystic Lymphangioma-Like Adenomatoid Tumor of the Adrenal Gland: Report of a Rare Case and Review of the Literature
    Int J Clin Exp Pathol 2013;6(5):943-950 www.ijcep.com /ISSN:1936-2625/IJCEP1302009 Case Report Cystic lymphangioma-like adenomatoid tumor of the adrenal gland: report of a rare case and review of the literature Ming Zhao1, Changshui Li1, Jiangjiang Zheng1, Minghui Yan2, Ke Sun3, Zhaoming Wang3 1Department of Pathology, 2Department of Radiology, Ningbo Yinzhou Second Hospital, Ningbo, Zhejiang Prov- ince, PR China; 3Department of Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China Received February 6, 2013; Accepted March 19, 2013; Epub April 15, 2013; Published April 30, 2013 Abstract: Adenomatoid tumors (AT) are uncommon, benign tumors of mesothelial origination most frequently en- countered in the genital tracts of both sexes. Their occurrences in the extragenital sites are much rarer and could elicit a variety of differential diagnosis both clinically and morphologically. With regard to the adrenal gland, to the best knowledge of us, only 31 cases of AT have been reported in the English literature. Several histologic growth patterns have been documented in AT, among which cystic type is the least common one. We herein present a fur- ther case of AT arising in the adrenal of a 62-year-old Chinese man with a medical history for systemic hypertensive disease. The tumor was incidentally identified during routine medical examination. An abdomen computed tomog- raphy scan revealed a solitary mass in the right adrenal. Grossly, the poorly-circumscribed mass measured 3.0 x 3.0 x 2.0 cm with a cut surface showing a gelatinous texture with numerous tiny cystic structures.
    [Show full text]
  • Ovarian Tumors Histogenesis and Systemic Effects
    Ovarian Tumors Histogenesis and Systemic Effects H. FOX, M.D., San Francisco * Sufficient histologic and embryologic information is now available to allow for a reasonably satisfactory histogenic classification of ovarian neoplasms. The majority of these tumors are derived from germ cells, sex cord-mesenchyme or the germinal epithelium. A few, such as the Brenner tumor, must stiU be classed as being of "uncertain histogenesis," for the cell (or tissue) of origin is not yet known. It is now realized that many ovarian neoplasms previously considered to be endocrinologically inert may, on occasion, be associated with either estrogenic or androgenic activity. This applies particularly to Brenner tumors, mucinous cystadenomas and serous cystadenomas. The common factor associated with such endocrine activity is luteinization of the tumor stroma. Ovarian neoplasms usually manifest only local symptoms, but they may, on occasion, be associated with such unusual systemic effects as hypoglycemia, hypercalcemia or a hemolytic anemia. THIS REVIEW PRESENTS a classification of primary accepted for no other hypothesis can explain either ovarian tumors that is based on current histogene- the dominance of the gonads as a site for such tic concepts; it is not proposed to discuss each neoplasms or the finding that whilst ovarian tera- tumor but to consider briefly only those neoplasms tomas are invariably sex chromatin positive, those about which fresh information has accrued in occurring in the testis may show either a male or recent years and to review also recent data con- a female sex chromatin pattern.46 The question cerning systemic manifestations of ovarian tumor. whether a teratoma develops by fusion of two with neoplastic transformation of the A.
    [Show full text]
  • Genitourinary Radiology: Case Review Dr. Vijayanadh Ojili
    Genitourinary Radiology: Case Review Dr. Vijayanadh Ojili Associate Professor and Fellowship Program Director Body Imaging and Intervention UT Health San Antonio DISCLOSURE OF COMMERCIAL INTEREST Neither I nor my immediate family members have a financial relationship with a commercial organization that may have a direct or indirect interest in the content Case: 1 Case: 1 Companion Case Penile Malignancy versus Penile Fracture with Hematoma Teaching Point: Contrast-Enhanced MRI (especially the subtraction images) play a crucial role in differentiation; although, clinical history provides a diagnostic clue in most cases Case: 3 USG-Penis Case 3: Peyronie’s Disease Teaching Point: Penile deformity and calcifications (calcified penile plaques) are important pointers to the diagnosis of Peyronie’s disease. Case: 4 Case: 4 Large RP Mass – Metastatic Testicular Cancer on a Background of Testicular Microlithiasis Related Case : Burnt Out Testicular Tumor with Extensive Pulmonary Metastases Companion Case Companion Case USG-Testis Case Provider: V Surabhi Companion Case Right Testis Left Testis Companion Cases Testicular Lymphoma Testicular Epidermoid Testicular Hamartomas RightTeaching Testis Points: Lymphoma-Homogenous, Bilateral, Increased Vascularity Epidermoid- Classic “onion skin “ appearance Hamartomas-Multiple, hyperechoic, Cowdens Syndrome Case: 9 Case 9: Adenomatoid Tumor of the Epidydimis Teaching Point: Intra-testicular tumors are usually malignant whereas extra-testicular tumors are usually benign Case: 10 Case 10: Dilated/Ectasia of the Rete Testis Teaching Point: Ectasia of the Rete Testis may be unilateral or bilateral and may be associated with spermatoceles. Intra-testicular varicocele which is a rare entity, may mimic this on gray scale sonography Case: 11 USG Scrotum Case 11: Fournier’s Gangrene Teaching Point: Absence of subcutaneous air in the scrotum or perineum does not exclude the diagnosis of Fournier’s gangrene.
    [Show full text]
  • Pleural & Peritoneal Tumors
    Last updated: 9/7/2020 Prepared by Kurt Schaberg Pleural & Peritoneal Tumors Non-neoplastic Mesothelial markers: D2-40, Calretinin, WT-1, CK5/6 (Not entirely specific) Pancytokeratin can be helpful to highlight invasion, but is not specific at all. Reactive Mesothelial Hyperplasia “Activated” reactive mesothelial cells, often responding to inflammation/irritation, can look very scary and mimic mesothelioma/carcinoma. Common scary findings: High cellularity, mitotic figures, cytologic atypia, papillary groups, and entrapment of mesothelial cells in fibrous tissue mimicking invasion. Can see “layering” as additional layers of mesothelium and fibrous tissue organize over one another. Think: sedimentary rock Figure from: Churg and Galateau-Salle. Arch Pathol Lab Med (2012) 136 (10): 1217–1226 Reactive Mesothelial Hyperplasia Mesothelioma Absence of stromal invasion (beware of entrapment Stromal invasion usually apparent (highlight with and tangential sectioning) pancytokeratin staining) Cellularity may be prominent but is confined to the Dense cellularity, including cells surrounded by stroma mesothelial surface/pleural space and is not in the stroma Simple papillae; single cell layers Complex papillae; tubules and cellular stratification Loose sheets of cells without stroma Cells surrounded by stroma (‘‘bulky tumor’’ may involve the mesothelial space without obvious invasion) Necrosis rare Necrosis occasionally present Inflammation common Minimal inflammation (usually) Uniform growth (highlighted with cytokeratin staining) Expansile nodules; disorganized growth (highlighted on cytokeratin staining) Usually Not Helpful: Mitotic activity, Mild to moderate cellular atypia Modified from: Husain AN et al. Guidelines for Pathologic Diagnosis of Malignant Mesothelioma 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group. Arch Pathol Lab Med. 2018 Jan;142(1):89-108.
    [Show full text]
  • Adenomatoid Tumors of the Testis: Report of a Case with a Focus on Histogenesis, Clinico-Pathologic Characteristics and Differential Diagnoses of These Rare Neoplasms
    WCRJ 2015; 2 (4): e606 ADENOMATOID TUMORS OF THE TESTIS: REPORT OF A CASE WITH A FOCUS ON HISTOGENESIS, CLINICO-PATHOLOGIC CHARACTERISTICS AND DIFFERENTIAL DIAGNOSES OF THESE RARE NEOPLASMS L. ALESSANDRINI1 , F. ITALIA3, T. PERIN1,2, A. LLESHI4, V. CANZONIERI1,2 1Division of Pathology, CRO Aviano National Cancer Institute, Aviano (PN) Italy; 2CRO-Biobank, CRO Aviano National Cancer Institute, Pordenone, Italy. 3Oncopath Lab, Floridia, SR, Italy. 4Medical Oncology A, CRO Aviano National Cancer Institute, Aviano (PN), Italy. ABSTRACT – Adenomatoid tumors (ATs) are relatively uncommon benign tumors usually arising in the paratesticular area. Among different theories proposed for its histogenesis, the most favored one seems to be the mesothelial origin, supported by different immunohistochemical and ultrastructural studies. As a consequence of the variety of morphologic patterns observed for ATs, the differential di- agnosis of these tumors is quite extensive, ranging from benign to malignant tumors of both epithe- lial and stromal origin. These tumors represent a diagnostic challenge due to their clinical signs similar to those of other testicular neoplasms and ultrasonography nonspecific findings. The importance of a correct diagnosis implies avoidance of unnecessary orchiectomy, thereby maintaining endogenous testosterone production and fertility potential at its fullest. Clinical outcome is excellent in all cases, with no published relapses, and follow-up by postoperative ultrasound is sufficient. We report a case of AT occurring in the tunica albuginea of the right testis in a 48-year-old man, referred to our Institute for a diagnostic revision. A brief review of the literature is also addressed, with a focus on histogenesis, clinico-pathologic characteristics and differential diagnoses of these rare neoplasms.
    [Show full text]