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Presented by Dr. Matoso and prepared by N. Giraldo-Castillo
This case talks about a adult male with scrotal mass.
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1. Question
Adult male with scrotal mass. Choose the correct diagnosis:
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Histology: Proliferation of cords of tumor cells forming tubules, with cytoplasmic vacuoles and surrounded by prominent smooth muscle.
Discussion: Adenomatoid tumors present as a scrotal mass and are usually suspected by image studies and therefore frequently excised and submitted for frozen section by the surgeon with the goal to avoid a complete orchiectomy. Tumor cells have bland nuclei with open chromatin and arranged in cords or forming tubules and show intracytoplasmic clear vacuoles. The surrounding stroma often shows prominent smooth muscle differentiation and acquire a more reactive appearance in cases with infarction. While these tumors are most frequently paratesticular, they can occasionally involve testicular parenchyma. By immunohistochemistry, they are positive for mesothelial markers including calretinin and WT1, but are negative for SF1, which can be used in cases difficult to differentiate from Sertoli cell tumors.
References
Urol Case Rep. 2018 Nov; 21: 34–35.
Int J Clin Exp Pathol. 2015; 8(5): 5914–5918.
ScientificWorldJournal. 2004; 4: 11–15.Incorrect
Histology: Proliferation of cords of tumor cells forming tubules, with cytoplasmic vacuoles and surrounded by prominent smooth muscle.
Discussion: Adenomatoid tumors present as a scrotal mass and are usually suspected by image studies and therefore frequently excised and submitted for frozen section by the surgeon with the goal to avoid a complete orchiectomy. Tumor cells have bland nuclei with open chromatin and arranged in cords or forming tubules and show intracytoplasmic clear vacuoles. The surrounding stroma often shows prominent smooth muscle differentiation and acquire a more reactive appearance in cases with infarction. While these tumors are most frequently paratesticular, they can occasionally involve testicular parenchyma. By immunohistochemistry, they are positive for mesothelial markers including calretinin and WT1, but are negative for SF1, which can be used in cases difficult to differentiate from Sertoli cell tumors.
References
Urol Case Rep. 2018 Nov; 21: 34–35.
Int J Clin Exp Pathol. 2015; 8(5): 5914–5918.
ScientificWorldJournal. 2004; 4: 11–15.
