Abstract
We report a hitherto not documented case of primary mucinous cystadenoma arising in the spermatic cord within the right inguinal canal of a78-year-old man. The tumor was painless, hard and mobile. A computed tomography scan on the pelvis revealed an oval shaped, low attenuation mass, measuring 5.0x2.5x2.1 cm, that was present adjacent to the vas deferens. Grossly, the excised mass was multicystic mucinous tumor, filled with thick mucoid materials. Microscopically, the cystic wall was irregularly thickened. The cystic epithelium commonly showed short papillae lined by a single layer of columnar to cuboidal mucinous epithelial cells without significant stratification or cytologic atypia. Goblet cells were also frequently present. Immunohistochemically, the neoplastic cells showed positive reaction to carcinoembryonic antigen, cytokeratin 20, CDX2, epithelial membrane antigen, and CD15. However, they were negative for PAX8 and Wilms’ tumor 1 protein. Pathological diagnosis was a papillary mucinous cystadenoma of the spermatic cord. Although mucinous cystadenoma in this area is extremely rare, it is important that these lesions be recognized clinically and pathologically in order to avoid unnecessary radical surgery.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1720965948762004
Highlights
Primary tumors of the spermatic cord can be of many types, but cystadenoma is especially exceptional
To the best of our knowledge, this is the third report of primary cystadenoma in the spermatic cord since the original report by McCluggage et al in 1996 [1]
The present case was arisen from the spermatic cord within the inguinal canal outside the epididymis
Summary
Primary tumors of the spermatic cord can be of many types, but cystadenoma is especially exceptional. Areas of mucin extravasation into stroma were present, but there was no stromal invasion by tumor cells. Immunohistochemistry Immunohistochemically, the neoplastic cells showed diffuse positive staining to carcinoembryonic antigen (CEA; clone II-7; Dako, Glostrup, Denmark), cytokeratin 20 (CK20; clone Ks20.8; Lab Vision Corp., Fremont, CA, USA), CDX2 (clone DAK-CDX2; 1:25, DAKO) and epithelial membrane antigen (EMA; clone E29; Dako). They were focally positive for CD15 (clone Carb-3; Dako), but negative for PAX8 (clone PAX8R1; Abcam Inc., Cambridge, MA, USA) and Wilms’ tumor 1 protein (WT-1; clone 6 F-H2; Dako) (Figure 3). Follow-up After surgery, the patient has recovered well, and shows no recurrence at 8 months’ follow-up after local excision of the tumor
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