of the Collecting Duct and Rete Testis

and Pilar González-Peramato2



(1)
Department of Anatomy, Histology and Neuroscience, Universidad Autónoma de Madrid, Madrid, Spain

(2)
Department of Pathology, University Hospital La Paz, Universidad Autónoma de Madrid, Madrid, Spain

 



Keywords

Testicular neoplasmsCollecting duct neoplasmsSertoliform cystadenomaAdenocarcinoma of the rete testis


There are two primitive tumors of the rete testis: adenomas with a benign behavior and adenocarcinomas with a malignant outcome. According to their architectural pattern, adenomas can be solid (sertoliform cystadenoma), papillary (papillary cystadenoma), cystic (cystadenoma), or with a fibromatous stromal component (adenofibromas). In addition to the most common variety, adenocarcinomas of the rete testis include clear cell adenocarcinomas. Two cases have been chosen as representative of this group: a sertoliform cystadenoma and an adenocarcinoma; they both make it possible to comment on the differential diagnosis not only between them but also with other tumors, as it is the case of adenocarcinoma, both primary tumors of the testis and metastases.



Case 98. Sertoliform Cystadenoma


Clinical case. An 18-year-old patient who incidentally discovered an intratesticular nodule. Serum levels of testicular tumor markers were negative.


Pathological findings. The orchiectomy specimen shows a 5-mm in diameter tumor located in the testicular mediastinum. The tumor consists of a nodular proliferation that grows preferentially inside the cavities of the rete testis. The cells are cylindrical and arranged to form cords, tubules, and acini. The nucleus is spherical or slightly elongated with longitudinal folds and a small nucleolus. The cytoplasm is broad and eosinophilic. Besides the intracavitary growth, nests of cells within a fibrous, and hyalinized stroma are observed in the proximal testicular parenchyma. There is continuity between the tumor and the epithelium of the rete testis. The tumor shows neither necrosis nor vascular infiltration. The testicular parenchyma has a normal spermatogenesis.

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Fig. 1

Cross-section of the testicle. A well-defined tumor of expansive growth is observed at the level of the testicular mediastinum, which makes the rete testis hard to be seen


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Fig. 2

Intimate relationship between the tumor mass and the rete testis. The slits shown by the tumor correspond to rete testis cavities


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Fig. 3

The tumor cells adopt a solid growth that penetrates the rete testis cavities


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Fig. 4

The tumor cells adopt a tubular growth pattern with small lumens. There is continuity between the cylindrical tumor cells and the flattened epithelium of the rete testis


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Fig. 5

The tumor cells are columnar and have elongated nuclei with some folds. The cytoplasm is broad and eosinophilic. The tumor shows no mitosis


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Fig. 6

Tumor nodule formed by several cellular clusters surrounded by a fibrous stroma that separates it from the testicular parenchyma


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Fig. 7

At the periphery of the tumor, there are groups of tumor cells near a seminiferous tubule. The tumor cells are surrounded by fibrous tissue with some lymphoid cells

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Oct 1, 2020 | Posted by in UROLOGY | Comments Off on of the Collecting Duct and Rete Testis
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