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Sertoliform cystadenoma: a rare benign tumour of the rete testis.

Bremmer F, Schweyer S, Behnes CL, Blech M, Radzun HJ - Diagn Pathol (2013)

Bottom Line: They appear in patients from 26 to 62 years of age.Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed.Alpha feto protein (AFP), human chorionic gonadotropin (ß-HCG) and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, University of Göttingen, Göttingen, Germany. felix.bremmer@med.uni-goettingen.de

ABSTRACT

Unlabelled: Sertoliform cystadenoma of the rete testis represents an uncommon benign tumour. They appear in patients from 26 to 62 years of age. We describe a case of a 66-year-old man with a tumour in the area of the epididymal head. The tumour markers were not increased. Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed. The cut surface of this tumour was of grey/white color and showed small cysts. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component. Proliferative activity was not increased. Immunohistochemically the tumour cells were positiv for inhibin, S-100, and CD 99. Alpha feto protein (AFP), human chorionic gonadotropin (ß-HCG) and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed. As far as we know this is the sixth reported case of this tumour. Because of the benign nature of this tumour the correct diagnosis is important for the intra- and postoperative management. Here we present a case of this rare tumour and discuss potential differential diagnosis.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1956026143857335.

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Sertoliform cystadenoma of the rete testis: The tumour shows solid (A, H & E, ×40) and cystic areas (B, H & E, ×40). Between the tumour cells and cystic structures sclerotic aereas can be seen (C + D, H &E, ×200). The tumour arises from the rete testis (E, arrow, H&E, ×400) and shows a sertoliform growth pattern (F, H&E, ×400).
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Figure 2: Sertoliform cystadenoma of the rete testis: The tumour shows solid (A, H & E, ×40) and cystic areas (B, H & E, ×40). Between the tumour cells and cystic structures sclerotic aereas can be seen (C + D, H &E, ×200). The tumour arises from the rete testis (E, arrow, H&E, ×400) and shows a sertoliform growth pattern (F, H&E, ×400).

Mentions: The tumourfree testicular tissue showed regular tubules, regular spermatogenesis, and normal interstitial tissue. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. The uniform tumour cells were ordered in tubules and acini. The cytoplasm of the tumour cells was eosinophilic, the nuclei showed prominent nucleoli (Figure 2A-F). Proliferative activity revealed by Ki-67 staining was not increased (Figure 3C). In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component (Figure 3A). Immunohistochemical examination of the epithelial like tumour cells revealed positivity for inhibin (Figure 3B), S-100, and CD 99. The germ cell markers such as AFP, ß-HCG and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed. Keratin expression could not be seen in both tumour elements but revealed the cystic alterated rete testis invaded by the tumour (Figure 3D). Because of the sertoliform growth pattern, the cystic areas and the origin of the tumour from the testis a sertoliform cystadenoma of the rete testis was diagnosed. This diagnosis was attested by special opinion.


Sertoliform cystadenoma: a rare benign tumour of the rete testis.

Bremmer F, Schweyer S, Behnes CL, Blech M, Radzun HJ - Diagn Pathol (2013)

Sertoliform cystadenoma of the rete testis: The tumour shows solid (A, H & E, ×40) and cystic areas (B, H & E, ×40). Between the tumour cells and cystic structures sclerotic aereas can be seen (C + D, H &E, ×200). The tumour arises from the rete testis (E, arrow, H&E, ×400) and shows a sertoliform growth pattern (F, H&E, ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3584937&req=5

Figure 2: Sertoliform cystadenoma of the rete testis: The tumour shows solid (A, H & E, ×40) and cystic areas (B, H & E, ×40). Between the tumour cells and cystic structures sclerotic aereas can be seen (C + D, H &E, ×200). The tumour arises from the rete testis (E, arrow, H&E, ×400) and shows a sertoliform growth pattern (F, H&E, ×400).
Mentions: The tumourfree testicular tissue showed regular tubules, regular spermatogenesis, and normal interstitial tissue. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. The uniform tumour cells were ordered in tubules and acini. The cytoplasm of the tumour cells was eosinophilic, the nuclei showed prominent nucleoli (Figure 2A-F). Proliferative activity revealed by Ki-67 staining was not increased (Figure 3C). In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component (Figure 3A). Immunohistochemical examination of the epithelial like tumour cells revealed positivity for inhibin (Figure 3B), S-100, and CD 99. The germ cell markers such as AFP, ß-HCG and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed. Keratin expression could not be seen in both tumour elements but revealed the cystic alterated rete testis invaded by the tumour (Figure 3D). Because of the sertoliform growth pattern, the cystic areas and the origin of the tumour from the testis a sertoliform cystadenoma of the rete testis was diagnosed. This diagnosis was attested by special opinion.

Bottom Line: They appear in patients from 26 to 62 years of age.Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed.Alpha feto protein (AFP), human chorionic gonadotropin (ß-HCG) and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, University of Göttingen, Göttingen, Germany. felix.bremmer@med.uni-goettingen.de

ABSTRACT

Unlabelled: Sertoliform cystadenoma of the rete testis represents an uncommon benign tumour. They appear in patients from 26 to 62 years of age. We describe a case of a 66-year-old man with a tumour in the area of the epididymal head. The tumour markers were not increased. Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed. The cut surface of this tumour was of grey/white color and showed small cysts. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component. Proliferative activity was not increased. Immunohistochemically the tumour cells were positiv for inhibin, S-100, and CD 99. Alpha feto protein (AFP), human chorionic gonadotropin (ß-HCG) and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed. As far as we know this is the sixth reported case of this tumour. Because of the benign nature of this tumour the correct diagnosis is important for the intra- and postoperative management. Here we present a case of this rare tumour and discuss potential differential diagnosis.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1956026143857335.

Show MeSH
Related in: MedlinePlus