Serous borderline tumor of the paratestis
ABSTRACT Reported herein is a case of serous borderline tumor (SBT, ovarian epithelial type tumor) of the paratestis, involving the tunica vaginalis, in a 64-year-old man. The patient complained of right hydrocele; puncture cytology of the turbid fluid pointed to an adenocarcinoma. Right orchiectomy was performed and multiple micronodules were grossly observed in the paratestis. On microscopy small papillary epithelial lesions were found with psammoma bodies and intraglandular papillary lesions were irregularly recognized in the stroma of the paratestis, similar to SBT of the ovary. The tumor cells had often short microvilli. Mucin production was evident on PAS and colloid iron staining. Both papillary and glandular epithelial cells were positive on immunohistochemistry for Ber-EP4/epithelial antigen, low-molecular-weight cytokeratin (CAM5.2), cytokeratin 7 and estrogen and progesterone hormone receptors, but negative for CEA, cytokeratin 20 and calretinin. The average proliferative index was approximately 10.5% as assessed on Ki-67 (MIB-1) staining. Ultrastructurally, the cells did not demonstrate any well-developed microvilli or secretory granules and immunohistochemical findings supported SBT of Müllerian type (ovarian epithelial type tumor), while excluding a papillary type of malignant mesothelioma. The lesion in the present case was concluded to be a testicular serous tumor of Müllerian type, similar to SBT of the ovary.
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ABSTRACT: PAX8 and PAX2 are cell-lineage-specific transcription factors that are essential for the development of Wolffian and Müllerian ducts and have recently emerged as specific diagnostic markers for tumors of renal or Müllerian origin. Little is known about their expression in the Wolffian duct-derived human male genital tract. We report our findings of PAX8 and PAX2 expression in the epithelium of the normal male genital tract and in epithelial tumors derived therefrom using immunohistochemistry (IHC). We found that PAX8 and PAX2 were expressed in the epithelium of the male genital tract from the rete testis to the ejaculatory duct. Rare glands in the prostatic central zone, a tissue of purported Wolffian duct origin, were focally positive for PAX2, but no PAX8 was detected in this area, a finding that may warrant further study. We found diffuse expression of PAX8 and PAX2 in 1 case each of serous cystadenoma of the epididymis, carcinoma of the rete testis, Wolffian adnexal tumor of the seminal vesicle, and endometrioid carcinoma of the seminal vesicle. Neither PAX8 nor PAX2 was detected in the seminiferous tubules and interstitium of the normal testis, nor in Leydig cell tumors (n=6), Sertoli cell tumors (n=2), or 48 of 49 germ cell tumors. One pediatric yolk sac tumor showed focal and weak staining for PAX8. Tumors of mesothelial origin, that is, adenomatoid tumors (n=3) and peritoneal malignant mesotheliomas (n=37) in men, were negative for PAX2 and PAX8. Neither PAX2 nor PAX8 was present in other areas of the prostate. Expression of PAX8 and PAX2 in these primary epithelial neoplasms of the male genital tract is due to their histogenetic relationship with Wolffian or Müllerian ducts. PAX8 and PAX2 IHC may facilitate the diagnosis of these tumors and should be included in the differential diagnostic IHC panel.The American journal of surgical pathology 09/2011; 35(10):1473-83. DOI:10.1097/PAS.0b013e318227e2ee · 4.59 Impact Factor
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ABSTRACT: Serous tumours of the testis and paratestis are rare, with fewer than 50 cases reported in the literature. The majority of the reported cases have been borderline serous tumours, and these tend not to recur or metastasize. Conversely, serous carcinomas can metastasize but this is often a late event. The presence of invasion in an otherwise borderline tumour has also been associated with the development of metastatic disease several years later, thus highlighting the importance of extensive sampling of all cases of borderline serous tumours. We report a case of a young man diagnosed with serous carcinoma of the testis, occurring 18 years after first diagnosis of a testicular germ cell tumour in the contralateral testis. This pattern has not previously been reported.Case Reports in Oncology 04/2011; 4(1):246-9. DOI:10.1159/000327989
- Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 01/2010; 29(1):135-9. · 1.53 Impact Factor