Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis: Case report

Edgar Paez,Ahmed Abroaf,Rajan Veeratterapillay,Nikhil Vasdev,Joaquim Majo,Amira El-Sherif

doi:10.14319/ijcto.0202.1

Abstract

We describe the case of a 65 year-old male presenting with a tender right testicular mass, confirmed to be a tumour on ultrasound. The patient underwent a radical inguinal orchidectomy and histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. This is an infrequent benign tumour of mesothelial origin that has rarely been reported as multiple lesions in the literature. Immunohistochemistry demonstrates that adenomatoid tumour and mesotheliomas share the expression of podoplanin (D2-40) which is helpful to differentiate them from carcinomas. On the other hand adenomatoid tumour is differentiated from mesothelioma on morphological grounds since the former does not exhibit cellular atypia, mitotic activity or bland focal tumour necrosis. Although testis preserving surgery can be an option for benign adenomatoid tumours, most patients (as in our case) proceed to orchidectomy as diagnosing them confidently can be difficult. --------------------------- Cite this article as: Abroaf A, Veeratterapillay R, Vasdev N, Majo J, Sherif AE, Paez E. Multiple adenomatoid tumours in the Epididymis and Tunica vaginalis : Case Report. Int J Cancer Ther Oncol 2014; 2 (1):02021. DOI : http://dx.doi.org/10.14319/ijcto.0202.1

Highlights

Testicular tumours whether benign or malignant, have to be diagnosed accurately and treated promptly
Adenomatoid tumours are infrequent in the male genital tract
Adenomatoid tumours of the male genital tract are rare but most commonly involve the epididymis involvement of the tunica albuginea, spermatic cord and ejaculatory ducts have been described.[1,2]

Summary

Introduction

Testicular tumours whether benign or malignant, have to be diagnosed accurately and treated promptly. We describe the case of a patient who was diagnosed with testicular tumour on ultrasound. The patient went on to have an inguinal orchidectomy and the histology revealed multiple adenomatoid tumours in epididymis and tunica vaginalis. The Ultrasound performed showed an echogenic mass measuring 32 × 24 × 29 mm situated at the upper pole of the right testis between the testis and the epididymal head consistent with a tumour. Pathology of the excised specimen showed an epididymal well circumscribed tumour measuring 30x22mm along with multiple nodules in the parietal tunica vaginalis up to two millimetres (Figure 1). Immunohistochemistry demonstrated that these cells expressed pancytokeratin AE1/AE3 (Figure 2C), D2-40 (Figure 2D) and EMA, but they did not express calretinin, CEA, CD31, CD34, CD30, PLAP, Alfa-FP or HCG. The testicular parenchyma showed preserved architecture with unremarkable seminiferous tubules and there was no evidence of intra tubular germ cell neoplasia

Discussion

Conclusion