Primary adenocarcinoma of the rete testis with elevated serum CA19-9 antigen levels

Abstract

Primary adenocarcinoma of the rete testis is an extremely rare tumor with a poor prognosis. Herein, we report a case of primary adenocarcinoma of the rete testis accompanied by elevated serum carbohydrate antigen 19-9 (CA19-9) antigen levels in a 44-year-old man who presented with left scrotal swelling. Para-aortic lymph node swelling was observed on the computed tomography scan. Germ cell tumor markers were within the normal range, but serum CA19-9 antigen levels were high. Radical orchiectomy was performed, and histological examination revealed primary adenocarcinoma of the rete testis with no evidence of other primary carcinomas. The patient underwent three lines of chemotherapy, although no reports suggest the use of gemcitabine and oxaliplatin (GEMOX) in a patient with adenocarcinoma of the rete testis. Unfortunately, he developed metastasis at multiple sites and passed away due to adenocarcinoma 13 months after undergoing orchiectomy. Some reports suggest that CA19-9 antigen levels are elevated in patients with adenocarcinoma of the rete testis, although it has not been clarified whether elevated CA19-9 antigen levels reflect the progression of adenocarcinoma of the rete testis. In this case, as CA19-9 antigen levels increased with progression, CA19-9 might be a marker for primary adenocarcinoma of the rete testis. GEMOX chemotherapy as a line of treatment in primary adenocarcinoma of the rete testis has not been reported. Therefore, further studies must evaluate the efficacy of the aforementioned chemotherapy regimen.

Adenocarcinoma of the Rete Testis: A Case Report

“…Similarly, Kitano et al [8] identified carbohydrate antigen 19-9 (CA 19-9) as a potential new biomarker for monitoring rete testis adenocarcinoma metastasis. Their case revealed a 44-year-old-man whose serum CA 19-9 levels rose as their tumor metastasis progressed.…”

“…Tumor size has been reported as a prognostic factor [11]; however, reanalysis of the original data lacked statistical significance [1]. Evidence has demonstrated that all chemotherapy regimens attempted to date have shown no statistical benefit to overall survival [1,4,8,[11][12][13]. Tumor confinement to the testis appears to be the only proven predictor of survival, with an 18% three-year survival in patients with metastasis.…”

Sunitinib for adenocarcinoma of the rete testis: a case report

“…Cases reported by Kitano et al. showed that serum CA 199 levels increase with the progression of AORT metastasis ( 7 ). There have also been reports of primary AORT associated with elevated serum CEA ( 8 ).…”

Primary undifferentiated carcinoma of rete testis with extensive peritoneal carcinomatosis and fatal outcome: Case report

“…Prognosis is very poor and most patients have developed metastases at the time of diagnosis. 2 , 3 , 4 , 5 The 3- and 5- year disease-free survival rates are 49% and 13% respectively 5 , 6 and a median survival time 33 months. 7 There are no specific clinical symptoms and tumor markers are normal.…”

“…Primary carcinoma of the rete testis is an extremely rare malignant tumor arising from the epithelium of the rete testis. 1 , 2 , 3 , 4 , 5 There are a few criteria that need to be fulfilled to diagnose adenocarcinoma of the rete testis: a tumor located in the center of the testicular hilum, the nonexistence of other extrascrotal tumors with similar histology, the morphology of the tumor is incompatible with any other type of testicular or paratesticular tumor, and other primary tumors of this site, such as malignant mesothelioma, papillary serous carcinoma and malignant Sertoli cell tumor, should be excluded. 1 The diagnosis is based on immunohistochemical exclusion of other possibilities, and most importantly the finding of transition from benign to malignant epithelium of the rete testis.…”