Sertoliform cystadenoma: a rare benign tumour of the rete testis

Abstract

Sertoliform cystadenoma of the rete testis represents an uncommon benign tumour. They appear in patients from 26 to 62 years of age. We describe a case of a 66-year-old man with a tumour in the area of the epididymal head. The tumour markers were not increased. Under the assumption of a malignant testicular tumour an inguinal orchiectomy was performed. The cut surface of this tumour was of grey/white color and showed small cysts. The tumour consisted of two compartments. The epithelial like tumour cells showed a sertoliform growth pattern and cystic dilatations. In between the tumour cells repeatedly actin expressing sclerotic areas could be recognized as the second tumour component. Proliferative activity was not increased. Immunohistochemically the tumour cells were positiv for inhibin, S-100, and CD 99. Alpha feto protein (AFP), human chorionic gonadotropin (ß-HCG) and placental alkaline phosphatase (PLAP) as well as synaptophysin, epithelial membrane antigene (EMA), and BCL-2 were not expressed. As far as we know this is the sixth reported case of this tumour. Because of the benign nature of this tumour the correct diagnosis is important for the intra- and postoperative management. Here we present a case of this rare tumour and discuss potential differential diagnosis.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1956026143857335

Sertoliform Cystadenoma of the Rete Testis: Report of a Case and Review of the Literature

“…Likewise, neuroendocrine markers, synaptophysin, chromogranin, and CD56 are not expressed (Table 1). 3,5,8 In our patient, immunohistochemical staining revealed strong positivity for inhibin, CAM5.2, PAX8, with weak staining for calretinin. In fetal life, the rete testis connects the seminiferous tubules with mesonephric tubules and is presumed to be derived from both mesonephric duct and sex cord elements.…”

“…Sertoliform cystadenoma is a distinct rare tumor of the rete testis with 8 case reports in the literature. 2-5 There are also 14 cases that have only appeared in abstract form. 6 They have been reported in patients from 19 to 84 years of age and may vary in size from microscopic to 4 cm.…”

“…Grossly, the tumors are present in the hilum, well-circumscribed, and have a gray-white color with cystic areas. 3,5,8 On histologic evaluation, the tumor arises from the rete testis helping to distinguish it from testicular neoplasms. 1 The tumor has a predominantly tubular/nested architecture, but a solid growth pattern, individual cells, festoons, branching tubules, and papillary patterns may be observed.…”

Comprehensive Immunophenotypic Characterization of Adult and Fetal Testes, the Excretory Duct System, and Testicular and Epididymal Appendages

“…25,26 Benign and malignant epithelial tumors derived from RT and the excretory duct system are rare and poorly characterized from an immunophenotypic perspective. 24,[27][28][29] If these rare testicular neoplasms are in fact derived from RT and retain some or all of the normal RT immunophenotype, then the expectation is that they would express CK7, PAX8, WT1, calretinin, and AR. Similarly, benign and malignant mesothelial proliferations, including adenomatoid tumor, mesothelial hyperplasia, and mesothelioma, can occur in the testis/ paratestis.…”

A case of adenocarcinoma of the rete testis accompanied by focal adenomatous hyperplasia

“…The differential diagnosis includes metastatic adenocarcinoma [18], malignant mesothelioma [19] and other uncommon tumors [20,21]. Metastatic adenocarcinoma can be ruled out based on the clinical history.…”