Objective Adult granulosa cell tumors (AGCTs) represent 2%–5% of all ovarian malignancies. The aim of this study was to analyze clinical and pathohistological parameters and their impact on recurrence, overall, and disease-free survival in FIGO stage I AGCT patients. Methods The tumor specimens analyzed in this retrospective study were obtained from a total of 36 patients with diagnosis of ovarian AGCT surgically treated at the Department of Gynecology, Rijeka University Hospital Centre, between 1994 and 2012. Clinical, pathological, and follow-up data were collected. Results The mean age at diagnosis was 54.5 years with a range of 24–84. The majority of the patients, 30 (83%), were in FIGO stage IA, 3 (8%) in stage IC1, 1 (3%) in stage IC2, and 2 (6%) in stage IC3. During follow-up period (median 117.5 months, range 26–276), recurrence occurred in 4 patients (12%) with 2 deaths of the disease recorded. In univariate analysis, the 5-year survival rates were significantly shorter in patients with FIGO substage IC (p = 0.019), with positive LVSI (p = 0.022), with presence of necrosis (p = 0.040), and with hemorrhage (p = 0.017). In univariate analysis, the 5-year disease-free survival rates were significantly shorter in patients treated with fertility surgery (p = 0.004), with diffuse growth pattern (p = 0.012), with moderate and severe nuclear atypia (p = 0.032), and with presence of hemorrhage (p = 0.022). FIGO substage IC proved to be independent predictor for recurrence (OR = 16.87, p = 0.015, and OR = 23.49, p = 0.023, resp.) and disease-free survival (p = 0.0002; HR 20.84, p = 0.02) at the uni- and multivariate analyses. Conclusions FIGO substage IC is predictive of recurrence and disease-free survival in patients with early-stage AGCTs. LVSI, presence of necrosis and hemorrhage, diffuse growth pattern, and nuclear atypia in AGCTs seem to be associated with overall and disease-free survival, so these pathological features should be taken into consideration when managing patients with AGCT.

Background: A 31-year-old man was referred from an outside institution to the department of urology under the suspicion of a testicular tumor, with left-sided testicular pain lasting a couple of months in duration. Physical examination showed a hard, thickened and small left testis on palpation with diffuse, inhomogeneous ultrasonographic appearance. After urologic examination a left-sided inguinal orchiectomy was performed. The testis, epididymis and spermatic cord were sent to pathology. Case presentation: On gross examination, a cystic cavity filled with brown fluid content and surrounding brownish parenchyma measuring up to 3.5 cm in diameter was found. Histologic examination showed cystically dilated rete testis lined with cuboidal epithelium and a positive immunohistochemical reaction to cytokeratins. The cystic cavity was microscopically a pseudocyst filled with extravasated erythrocytes and abundant clusters of siderophages. The siderophages extended into the testicular parenchyma, surrounding the seminiferous tubules and spreading out around ducts of the epididymis, which were also cystically dilated with siderophages inside their lumina. Conclusions: On the basis of clinical data, histological and immunohistochemical analysis, a diagnosis of cystic dysplasia of the rete testis was established. According to the literature there is a very well-known association between cystic dysplasia of rete testis and ipsilateral genitourinary anomalies. The patient was referred to the department of radiology, and a multi-slice computed tomography scan revealed ipsilateral renal agenesis, right seminal vesicle cyst reaching up to the iliac arteries and a multi-cystic formation cranial to the prostate.

A 31-year-old man with left-sided testicular pain lasting a couple of months was referred to our urology department due to a suspected testicular tumor. Physical examination showed a hard, thickened, and small left testis on palpation with a diffuse, inhomogeneous ultrasonographic appearance. After a urologic examination, a left-sided inguinal orchiectomy was performed. The testis, epididymis, and spermatic cord were sent to pathology. Gross examination revealed a cystic cavity filled with brown fluid and the surrounding brownish parenchyma measuring up to 3.5 cm in diameter. Histologic examination showed a cystically dilated rete testis lined with cuboidal epithelium and a positive immunohistochemical reaction to cytokeratins. Microscopically, the cystic cavity was a pseudocyst filled with extravasated erythrocytes and abundant clusters of siderophages. The siderophages extended into the testicular parenchyma, surrounding the seminiferous tubules and spreading out around the ducts of the epididymis, which were also cystically dilated with siderophages inside their lumina. On the basis of clinical data, histological, and immunohistochemical analysis, the patient was diagnosed with cystic dysplasia of the rete testis. The literature shows an association between cystic dysplasia of the rete testis and ipsilateral genitourinary anomalies. Therefore, our patient underwent a multi-slice computed tomography scan, which revealed ipsilateral renal agenesis, a right seminal vesicle cyst reaching up to the iliac arteries, and a multicystic formation cranial to the prostate.

We report a patient with polymorphous adenocarcinoma of the breast. Polymorphous adenocarcinoma of the breast is a rare tumour that corresponds to polymorphous adenocarcinoma in the salivary gland. The tumour consisted of a unimorphous population of one type of neoplastic cells with hyperchromatic, pleomorphic nuclei. Neoplastic cells were arranged in various architectural patterns including solid pattern, trabecular pattern and single “Indian-file“ arrangement with myxoid stroma in between. Tumour cells were negative for Estrogen, Progesterone, Her-2/neu, Smooth Muscle Actin, Cytokeratin 5/6, Cytokeratin 7, Synaptophysin and Chromogranin, while Cytokeratin AE1/AE3 (Pankeratin), BCL2 and E-cadherin were positive and p63 partially positive. Polymorphous adenocarcinoma is a rare and salivary gland-type tumour with only three cases reported up to date. To the best of our knowledge this is the fourth case of a polymorphous adenocarcinoma of the breast reported in the english literature.