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Müllerian serous cystadenoma of the scrotum following orchiopexy.

van der Putte SC, Toonstra J, Sie-Go DM - Adv Urol (2009)

Bottom Line: Histopathology revealed the lesion to be adenomatous and confined to the scrotum.However, the lesion did compare well with serous (papillary) cystadenomas of the testis or paratestis.Complete excision of the lesion appears to be an adequate therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands. s.c.j.vandeputte@umcutrecht.nl

ABSTRACT
A 24-year-old man presented himself with a nodular lesion of about 1 cm diameter at the site of a previous orchiopexy associated with surgery for cryptorchism. Histopathology revealed the lesion to be adenomatous and confined to the scrotum. Histological and immunohistological features were not consistent neither with median raphe cysts or cutaneous adenomas nor with the intrascrotal adenomas of the rete testis, epididymis, nor with (malignant) mesotheliomas. However, the lesion did compare well with serous (papillary) cystadenomas of the testis or paratestis. These adenomas are thought to originate in remnants of the Müllerian system or of peritoneal lining altered by Müllerian metaplasia. This implies that the scrotal adenoma may have developed from an implant of such elements during orchiopexy 14 years ago. Complete excision of the lesion appears to be an adequate therapy.

No MeSH data available.


Related in: MedlinePlus

Histologicaland immunohistochemical features of the scrotal serous cystadenoma at the sideof an orchiopexy 14 years earlier. (a)Low magnification shows a tubulocystic tumor (between large arrowheads)surrounded by connective tissue and embedded in the dartos fascia (asterisks). Note its connection to the epidermis by a sinus (1) lined by cornifyingstratified squamous epithelium and opening at the surface (arrow). (b) Detail of metaplastic noncornifyingstratified squamous epithelium (2) passing into a single-layered columnarepithelium of the tubulocystic system (3) in the deepest part of the sinus. (c) Cystic papillary component. (d) Detail of a fibrous papilla coveredby characteristic tall columnar epithelium with ciliated cells (smallarrowheads). (e) Cytological and immunohistochemical characteristics discriminatingthe tumor from other scrotal and intrascrotal lesions. Vim: Vimentin; ER: Estrogen receptor; PR: Progesterone receptor; Calret: Calretinin; SMA: Smooth muscle actin.
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fig1: Histologicaland immunohistochemical features of the scrotal serous cystadenoma at the sideof an orchiopexy 14 years earlier. (a)Low magnification shows a tubulocystic tumor (between large arrowheads)surrounded by connective tissue and embedded in the dartos fascia (asterisks). Note its connection to the epidermis by a sinus (1) lined by cornifyingstratified squamous epithelium and opening at the surface (arrow). (b) Detail of metaplastic noncornifyingstratified squamous epithelium (2) passing into a single-layered columnarepithelium of the tubulocystic system (3) in the deepest part of the sinus. (c) Cystic papillary component. (d) Detail of a fibrous papilla coveredby characteristic tall columnar epithelium with ciliated cells (smallarrowheads). (e) Cytological and immunohistochemical characteristics discriminatingthe tumor from other scrotal and intrascrotal lesions. Vim: Vimentin; ER: Estrogen receptor; PR: Progesterone receptor; Calret: Calretinin; SMA: Smooth muscle actin.

Mentions: Macroscopy showed an ellipsoid 2.5 × 1.5 × 1 cm specimenwith a firm 1 cm tumor. Microscopic sections revealed an irregular tubulocysticepithelial proliferation surrounded by a mantle of connective tissue andembedded in the smooth musculature of the dartos fascia (Figure 1(a)). Thetumor was completely removed with a very narrow free margin. The tubulocysticelement spread outward from a central sinus that opened externally at thesurface of the skin and was lined by a cornifying stratified squamousepithelium (Figure 1(a)). Metaplastic noncornifying stratified squamousepithelium in the deepest part of the sinus passed into columnar to cuboidalepithelium in the tubulocystic component of the tumor (Figure 1(b)). Inaddition to the tubulocystic element, slit-like and papillary configurationswere also observed (Figures1(c), 1(d)). Variable numbers of cells showed prominent apical snouts or cilia(Figures 1(d), 1(e)). The epithelium was bland, mitotic figures were rare, and microinvasion wasabsent. Psammona bodies were not observed.


Müllerian serous cystadenoma of the scrotum following orchiopexy.

van der Putte SC, Toonstra J, Sie-Go DM - Adv Urol (2009)

Histologicaland immunohistochemical features of the scrotal serous cystadenoma at the sideof an orchiopexy 14 years earlier. (a)Low magnification shows a tubulocystic tumor (between large arrowheads)surrounded by connective tissue and embedded in the dartos fascia (asterisks). Note its connection to the epidermis by a sinus (1) lined by cornifyingstratified squamous epithelium and opening at the surface (arrow). (b) Detail of metaplastic noncornifyingstratified squamous epithelium (2) passing into a single-layered columnarepithelium of the tubulocystic system (3) in the deepest part of the sinus. (c) Cystic papillary component. (d) Detail of a fibrous papilla coveredby characteristic tall columnar epithelium with ciliated cells (smallarrowheads). (e) Cytological and immunohistochemical characteristics discriminatingthe tumor from other scrotal and intrascrotal lesions. Vim: Vimentin; ER: Estrogen receptor; PR: Progesterone receptor; Calret: Calretinin; SMA: Smooth muscle actin.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2662405&req=5

fig1: Histologicaland immunohistochemical features of the scrotal serous cystadenoma at the sideof an orchiopexy 14 years earlier. (a)Low magnification shows a tubulocystic tumor (between large arrowheads)surrounded by connective tissue and embedded in the dartos fascia (asterisks). Note its connection to the epidermis by a sinus (1) lined by cornifyingstratified squamous epithelium and opening at the surface (arrow). (b) Detail of metaplastic noncornifyingstratified squamous epithelium (2) passing into a single-layered columnarepithelium of the tubulocystic system (3) in the deepest part of the sinus. (c) Cystic papillary component. (d) Detail of a fibrous papilla coveredby characteristic tall columnar epithelium with ciliated cells (smallarrowheads). (e) Cytological and immunohistochemical characteristics discriminatingthe tumor from other scrotal and intrascrotal lesions. Vim: Vimentin; ER: Estrogen receptor; PR: Progesterone receptor; Calret: Calretinin; SMA: Smooth muscle actin.
Mentions: Macroscopy showed an ellipsoid 2.5 × 1.5 × 1 cm specimenwith a firm 1 cm tumor. Microscopic sections revealed an irregular tubulocysticepithelial proliferation surrounded by a mantle of connective tissue andembedded in the smooth musculature of the dartos fascia (Figure 1(a)). Thetumor was completely removed with a very narrow free margin. The tubulocysticelement spread outward from a central sinus that opened externally at thesurface of the skin and was lined by a cornifying stratified squamousepithelium (Figure 1(a)). Metaplastic noncornifying stratified squamousepithelium in the deepest part of the sinus passed into columnar to cuboidalepithelium in the tubulocystic component of the tumor (Figure 1(b)). Inaddition to the tubulocystic element, slit-like and papillary configurationswere also observed (Figures1(c), 1(d)). Variable numbers of cells showed prominent apical snouts or cilia(Figures 1(d), 1(e)). The epithelium was bland, mitotic figures were rare, and microinvasion wasabsent. Psammona bodies were not observed.

Bottom Line: Histopathology revealed the lesion to be adenomatous and confined to the scrotum.However, the lesion did compare well with serous (papillary) cystadenomas of the testis or paratestis.Complete excision of the lesion appears to be an adequate therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands. s.c.j.vandeputte@umcutrecht.nl

ABSTRACT
A 24-year-old man presented himself with a nodular lesion of about 1 cm diameter at the site of a previous orchiopexy associated with surgery for cryptorchism. Histopathology revealed the lesion to be adenomatous and confined to the scrotum. Histological and immunohistological features were not consistent neither with median raphe cysts or cutaneous adenomas nor with the intrascrotal adenomas of the rete testis, epididymis, nor with (malignant) mesotheliomas. However, the lesion did compare well with serous (papillary) cystadenomas of the testis or paratestis. These adenomas are thought to originate in remnants of the Müllerian system or of peritoneal lining altered by Müllerian metaplasia. This implies that the scrotal adenoma may have developed from an implant of such elements during orchiopexy 14 years ago. Complete excision of the lesion appears to be an adequate therapy.

No MeSH data available.


Related in: MedlinePlus