Adenomatoid tumor of intratesticular localization

Epididymal Adenomatoid Tumour: A Case Report

Adenomatoid tumours are rare benign neoplasm involving the para testicular region, mostly the tail of the epididymis. They are typically small, firm and asymptomatic masses in the scrotal region and often discovered incidentally during physical examination or imaging studies. It is very challenging to differentiate them clinically and radiologically from malignant intratesticular solid tumours, which may lead to unnecessary orchidectomies. This case report presents the clinical management of a 57-year-old male patient with adenomatoid tumour of the epididymis, highlighting the diagnostic workup, surgical approach and postoperative outcomes. In addition, a comprehensive literature review was conducted to discuss the morphological and immunohistochemical features to improve understanding of these rare lesions and assist in accurate diagnosis and appropriate management.

Testicular hemangioma: a series of 8 cases

Testicular hemangioma is a very rare neoplasm with only 25 cases reported in the English literature. We describe 8 cases of testicular hemangioma encountered at our institution between 1992 and 2012. Of the 7 consult cases, 4 were malignant, 1 a Leydig cell tumor, and 2 were recognized as hemangiomas. The patients' ages ranged from 9 to 54 years (mean 32; median 30). Seven patients presented with self-detected palpable masses, and 2 patients reported pain. Six hemangiomas involved the right testis, and 2 were left sided. Ultrasonography recognized hypervascularity in 3 cases. History of pelvic irradiation, chemotherapy, and remote scrotal trauma was present in 3 patients. Preoperative serum tumor markers were negative (2/2 cases). The average size was 1.7 cm (median 1.8; range, 0.5 to 3.0). Six cases were infiltrative within the testis and entrapped benign seminiferous tubules, and 3 tumors invaded the tunica albuginea. Three hemangiomas were epithelioid, 2 anastomosing, 1 cellular capillary, 1 capillary, and 1 cavernous. Mitoses were sparse in all but 1 case, which reached up to 5 per 10 HPF. In 6 cases, seminiferous tubules adjacent to the hemangioma were atrophic without spermatogenesis. Immunohistochemical analysis was performed in 6 cases, and tumors stained with CD31, CD34, FVIII-related protein, and FLI-1 but not with pancytokeratin AE1/3, epithelial membrane antigen, keratin 8/18, placental alkaline phosphatase, human herpes virus 8, human chorionic gonadotropin, c-kit, melan-A, or p53. In cases with follow-up, there were no recurrences in 7 patients (mean 21 mo; median 12 mo; range, 1 to 72 mo). In summary, testicular hemangioma is a rare neoplasm with different morphologies having in common an infiltrative growth pattern with entrapment of seminiferous tubules, which should not be considered a feature of malignancy. Clinical and radiologic findings may preoperatively suggest a vascular tumor.

Infarcted adenomatoid tumour of epididymis: a rare case report

Paratesticular tumours are pathologically rare. The vast majority are benign in nature with adenomatoid tumours representing the most common pathological entity. We present the case of a 32-year-old man, from the Indian subcontinent, who presented with a painful scrotal swelling sustained after trauma. The history suggested that the scrotal mass had been present for approximately 12 months, and a preliminary diagnosis of a haemorrhagic cyst caused by trauma was made. Initial management included scrotal support, analgesia, and a follow-up magnetic resonance imaging (MRI) scan. Subsequent imaging and then further histological analysis confirmed a partly necrotic/infarcted adenomatoid tumour of the right epididymis. After scrotal exploration and epididymectomy, the patient made a complete recovery, and, with the histological diagnosis, he was discharged with no further followup. The case is presented as a learning point in the identification and management of such pathologies.

Intraparenchymatous adenomatoid tumor dependent on the rete testis: A case report and review of literature

The adenomatoid tumor is the most frequent paratesticular tumor. It is a benign tumor, which in women is mainly found in the uterus and the fallopian tubes, while in men it is most frequently found in the epididymis. These lesions may also affect the testicular albuginea, the spermatic cord and, in exceptional cases, the testicular parenchyma, of which there are only 4 published cases, the ejaculatory ducts, prostate, etc. The clinical signs and imaging studies are, on many occasions, difficult to differentiate from malign intratesticular solid tumor, which can result in unnecessary orchidectomies. We present a new case of intraparenchymatous adenomatoid tumor dependent on the rete testis.

Adenomatoid Tumor of the Testis With Intratesticular Growth

Adenomatoid tumor of the male genitourinary tract is a rare benign neoplasm thought to be of mesothelial origin. In exceptional cases, these lesions may involve the testicular parenchyma, of which there are only 9 published cases in the literature. The authors describe a rare case of a testicular tumor in a 41-year-old male with normal tumor markers. Histopathology and immunohistochemical studies revealed an adenomatoid tumor with intratesticular growth. No involvement of the epididymis or testicular membranes was identified. The morphological clues leading to the correct diagnosis of adenomatoid tumor and the possible histogenesis and differential diagnosis are discussed.

Adenomatoid tumour of testis

Adenomatoid tumour is a rare neoplasm of mesothelial origin commonly seen in male and female genital tract. In this case report, the authors present a case of adenomatoid tumour in a 35-year-old male who presented with 1-year history of scrotal swelling. A clinical diagnosis of testicular neoplasm was made but final diagnosis of adenomatoid tumour was made after excisional biopsy.

Adenomatoid tumor of epididymidis: A case report

Background

Adenomatoid tumors are regarded as distinctive benign mesothelial neoplasms of the paratesticular region, most commonly occuring at the tail of the epididymidis.

Because of its rarity, the clinical and histopathological aspects are discussed.

Case presentation

We present the case of a 41-year-old patient with an adenomatoid tumour located in the tail of the left epididymis that referred to our department with gradual enlarged intrascrotal mass. The diagnosis was achieved by echography, and was confirmed by surgical excision and histological analysis.

Conclusion

Due to its low incidence in intrascrotal pathology, we believe it is important for the physician to be aware of this interesting entity in order to make a differential diagnosis from other inflammatory processes and to adopt the proper surgical approach.

Adenomatoidtumor des Hodens – eine seltene Entität

Adenomatoid tumor with intra-testicular localization is rare. Although most reported cases arise from the epididymis, rare cases have been reported in the testicular tunica, spermatic cord, ejaculatory ducts, prostate and suprarenal recess. Adenomatoid tumors occur in both sexes and are also found in the uterus, ovary and fallopian tubes of the female genital tract. Adenomatoid tumors are benign proliferations of mesothelial origin. We report the case of a 50-year-old male with an adenomatoid tumor of the left testis. Because of its rarity, the clinical, diagnostic and therapeutic aspects as well as the possibilities of testicular preservation are discussed.

Adenomatoid tumor of the tunica albuginea

Adenomatoid tumors are benign mesothelial tumors most commonly found in the paratesticular structures, especially the epididymis. Herein, we report a case of adenomatoid tumor originating in the tunica albuginea and mimicking an intratesticular neoplasm. We review the ultrasonographic presentation and literature regarding adenomatoid tumors originating in the tunica albuginea and testicular parenchyma.

Adenomatoid Tumors of the Female and Male Genital Tracts Express WT1

Adenomatoid tumors are benign proliferations most often encountered in the female and male genital tracts. The mesothelial phenotype of these unusual tumors has been established by a variety of ultrastructural and immunohistochemical studies, although their etiology is by no means certain. The expression of the Wilms' tumor suppressor gene, WT1, in normal, hyperplastic, and malignant mesothelial cells prompted us to analyze the expression pattern of WT1 in a series of 24 adenomatoid tumors occurring in the uterus, fallopian tube, ovary, epididymis, scrotum, and testis. Twenty-three of the tumors expressed WT1 protein and the same number expressed calretinin, another marker of mesothelial differentiation. The one tumor that failed to stain with calretinin was positive for WT1. These results provide further support for mesothelial differentiation of adenomatoid tumors and suggest that the presence of WT1 expression may be useful in the differential diagnosis of these uncommon neoplasms, especially when they present in unusual settings or expression of other mesothelial markers is absent.

Adenomatoid tumor of the genital tract: evidence of mesenchymal cell origin

The objective of this study was to re-examine the histogenesis of adenomatoid tumors. This benign neoplasm is characterized by gland-like structures with a pseudodinfiltrative pattern, usually involving fibromuscular tissue at a certain distance from an overlying surface mesothelium. Twenty cases of adenomatoid tumors and four cases of reactive submesothelial lesions, characterized by marked proliferation of subserosal mesenchymal cells, were reviewed. Nineteen of twenty adenomatoid tumors, including lesions with ill-defined borders, showed no connection with surface mesothelium. At the periphery of small tumors, isolated glands, clusters of epithelioid cells and single epithelioid, and spindled cells showing no connection to adjacent glands or cell clusters were identified. The tumor cells shared features with reactive subserosal stromal cells including an infiltrative pattern and histochemical and immunohistochemical properties. The differences between adenomatoid tumors and reactive submesothelial tissue are quantitative in nature: predominant amount of spindled cells in reactive submesothelial lesions, and predominant amount of gland-like structures in adenomatoid tumors. It is proposed that adenomatoid tumors arise from pluripotent mesenchymal cells that differentiate toward submesothelial cells and eventually mesothelial cells. This differentiation is probably induced by the adjacent submesothelial cells.