Difference between revisions of "Adenocarcinoma of the rete testis"

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'''Adenocarcinoma of the rete testis''', also '''rete testis adenocarcinoma''', is a very rare [[malignant]] tumour of the [[testis]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Adenocarcinoma of the rete testis - intermed mag.jpg
| Width      =
| Caption    = Adenocarcinoma of the rete testis. [[H&E stain]].
| Synonyms  =
| Micro      = atypical columnar or cuboidal cells, often with cigar-shaped nuclei; classically tubular or papillary architecture; transistion to normal appearing rete testis
| Subtypes  =
| LMDDx      = [[adenomatous hyperplasia of the rete testis]], [[Sertoli cell tumour]], [[malignant mesothelioma]], metastasis
| Stains    =
| IHC        = EMA +ve, [[CK7]] +ve, PSA -ve, calretinin -ve, CK5/6 -ve, PLAP -ve, [[AFP]] -ve, CD30 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      = hilar mass
| Grossing  = [[orchiectomy grossing]]
| Site      = [[paratesticular region]]/[[testis]] - see ''[[rete testis]]''
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = extremely rare
| Bloodwork  = markers for GCT typically normal
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = other testicular mass
| Tx        =
}}
'''Adenocarcinoma of the rete testis''', also '''rete testis adenocarcinoma''', is a very rare [[malignant]] tumour of the [[paratesticular region]]/[[testis]].


==General==
==General==
*Extremely rare - a few dozen cases in the world literature.<ref name=pmid3799821>{{Cite journal  | last1 = Newbold | first1 = RR. | last2 = Bullock | first2 = BC. | last3 = McLachlan | first3 = JA. | title = Adenocarcinoma of the rete testis. Diethylstilbestrol-induced lesions of the mouse rete testis. | journal = Am J Pathol | volume = 125 | issue = 3 | pages = 625-8 | month = Dec | year = 1986 | doi =  | PMID = 3799821 | PMC = 1888460 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888460/?page=1}}</ref>
*Extremely rare<ref name=pmid6465420>{{Cite journal  | last1 = Nochomovitz | first1 = LE. | last2 = Orenstein | first2 = JM. | title = Adenocarcinoma of the rete testis. Case report, ultrastructural observations, and clinicopathologic correlates. | journal = Am J Surg Pathol | volume = 8 | issue = 8 | pages = 625-34 | month = Aug | year = 1984 | doi =  | PMID = 6465420 }}</ref> - a few dozen cases in the world literature.
*Possible association of diethylstilbestrol.<ref name=pmid3799821/>
*Typically older men (>60 years old), but reported in younger men with undescended testis.<ref name=pmid6465420/>
*Possible association with diethylstilbestrol - based on non-human data.<ref name=pmid3799821>{{Cite journal  | last1 = Newbold | first1 = RR. | last2 = Bullock | first2 = BC. | last3 = McLachlan | first3 = JA. | title = Adenocarcinoma of the rete testis. Diethylstilbestrol-induced lesions of the mouse rete testis. | journal = Am J Pathol | volume = 125 | issue = 3 | pages = 625-8 | month = Dec | year = 1986 | doi =  | PMID = 3799821 | PMC = 1888460 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888460/?page=1}}</ref>
*Prognosis poor<ref name=pmid17853037>{{Cite journal  | last1 = Sogni | first1 = F. | last2 = Monga | first2 = G. | last3 = Terrone | first3 = C. | last4 = Gontero | first4 = P. | title = Primary adenocarcinoma of the rete testis: diagnostic problems and therapeutic dilemmas. | journal = Scand J Urol Nephrol | volume = 42 | issue = 1 | pages = 83-5 | month =  | year = 2008 | doi = 10.1080/00365590701517608 | PMID = 17853037 }}</ref> - 3-year and 5-year disease-free survival approximately 50% and 15% respectively.<ref name=pmid7571213>{{Cite journal  | last1 = Sánchez-Chapado | first1 = M. | last2 = Angulo | first2 = JC. | last3 = Haas | first3 = GP. | title = Adenocarcinoma of the rete testis. | journal = Urology | volume = 46 | issue = 4 | pages = 468-75 | month = Oct | year = 1995 | doi = 10.1016/S0090-4295(99)80257-X | PMID = 7571213 }}</ref>
 
Clinical:
*[[Germ cell tumour]] serum markers (LDH, AFP, beta-hCG) typically normal.
 
==Gross==
*Lesion of the testicular hilum.<ref name=pmid6465420/>


==Microscopic==
==Microscopic==
Features:
Features:
*Adenocarcinoma:
*Adenocarcinoma:
**Tubular or papillary architecture.<ref name=pmid3799821/>
**Atypical columnar or cuboidal cells, often with cigar-shaped nuclei.
**Columnar cells with cigar-shaped nuclei.
**Classically tubular or papillary architecture.<ref name=pmid3799821/>
*Transistion to normal appearing rete testis.<ref name=pmid6465420/>
 
DDx:
*[[Adenomatous hyperplasia of the rete testis]] - may be a concurrent pathology.<ref name=pmid23800084>{{Cite journal  | last1 = Lin | first1 = XY. | last2 = Yu | first2 = JH. | last3 = Xu | first3 = HT. | last4 = Wang | first4 = L. | last5 = Fan | first5 = CF. | last6 = Liu | first6 = Y. | last7 = Wang | first7 = EH. | title = A case of adenocarcinoma of the rete testis accompanied by focal adenomatous hyperplasia. | journal = Diagn Pathol | volume = 8 | issue =  | pages = 105 | month =  | year = 2013 | doi = 10.1186/1746-1596-8-105 | PMID = 23800084 }}</ref>
*[[Metastatic]] carcinoma involving the testis - usually [[prostate carcinoma|prostate]], kidney, or colon.<ref name=pmid18769334>{{Cite journal  | last1 = Ulbright | first1 = TM. | last2 = Young | first2 = RH. | title = Metastatic carcinoma to the testis: a clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features. | journal = Am J Surg Pathol | volume = 32 | issue = 11 | pages = 1683-93 | month = Nov | year = 2008 | doi = 10.1097/PAS.0b013e3181788516 | PMID = 18769334 }}</ref>
*[[Sertoli cell tumour]].
*[[Malignant mesothelioma]].<ref name=pmid6465420/>


===Images===
===Images===
<gallery>
<gallery>
Image:Adenocarcinoma_of_the_rete_testis_-_intermed_mag.jpg | Adenocarcinoma of the rete testis - intermed. mag. (WC/Nephron)
Image: Adenocarcinoma of the rete testis - low mag.jpg | ART - low mag. (WC)
Image:Adenocarcinoma_of_the_rete_testis_-_extra_-_high_mag.jpg | Adenocarcinoma of the rete testis - high mag. (WC/Nephron)
Image: Adenocarcinoma of the rete testis - intermed mag.jpg | ART - intermed. mag. (WC)
Image: Adenocarcinoma of the rete testis - extra - high mag.jpg | ART - high mag. (WC)
Image: Adenocarcinoma of the rete testis - high mag.jpg | ART - high mag. (WC)
Image: Adenocarcinoma of the rete testis - very high mag.jpg | ART - very high mag. (WC)
</gallery>
</gallery>
www:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886206/figure/f2-cuaj-9-10-e654/ ART (nih.gov)].<ref name=pmid24409217>{{Cite journal  | last1 = Yang | first1 = Z. | last2 = Sheng | first2 = C. | last3 = Cao | first3 = L. | last4 = Wang | first4 = D. | title = Adenocarcinoma of rete testis with widespread liver metastasis. | journal = Can Urol Assoc J | volume = 7 | issue = 9-10 | pages = E654-6 | month =  | year =  | doi = 10.5489/cuaj.470 | PMID = 24409217 }}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881943/figure/f2-ol-07-02-0455/ ART (nih.gov)].<ref name=pmid24396468>{{Cite journal  | last1 = Tian | first1 = Y. | last2 = Yao | first2 = W. | last3 = Yang | first3 = L. | last4 = Wang | first4 = J. | last5 = Wazir | first5 = R. | last6 = Wang | first6 = K. | title = Primary adenocarcinoma of the rete testis: A case report and review of the literature. | journal = Oncol Lett | volume = 7 | issue = 2 | pages = 455-457 | month = Feb | year = 2014 | doi = 10.3892/ol.2013.1708 | PMID = 24396468 }}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350189/figure/fig3/ ART (nih.gov)].<ref>{{Cite journal  | last1 = Wu | first1 = CA. | last2 = Chen | first2 = YH. | last3 = Man | first3 = KM. | last4 = Shen | first4 = JL. | last5 = Chen | first5 = WC. | title = Papillary adenocarcinoma of rete testis mimics inflammatory lump: a case report. | journal = Case Rep Urol | volume = 2011 | issue =  | pages = 857812 | month =  | year = 2011 | doi = 10.1155/2011/857812 | PMID = 22606627 }}</ref>
==IHC==
Features:<ref name=pmid23800084/>
*[[CK7]] +ve.
*[[EMA]] +ve.
Others:<ref name=pmid23800084/>
*[[AFP]] -ve.
*CD30 -ve.
*PLAP -ve.
*CK5/6 -ve.
*Calretinin -ve.
*[[PSA]] -ve.


==See also==
==See also==
Line 22: Line 88:


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Testis]]
[[Category:Testis]]

Latest revision as of 21:56, 29 September 2015

Adenocarcinoma of the rete testis
Diagnosis in short

Adenocarcinoma of the rete testis. H&E stain.
LM atypical columnar or cuboidal cells, often with cigar-shaped nuclei; classically tubular or papillary architecture; transistion to normal appearing rete testis
LM DDx adenomatous hyperplasia of the rete testis, Sertoli cell tumour, malignant mesothelioma, metastasis
IHC EMA +ve, CK7 +ve, PSA -ve, calretinin -ve, CK5/6 -ve, PLAP -ve, AFP -ve, CD30 -ve
Gross hilar mass
Grossing notes orchiectomy grossing
Site paratesticular region/testis - see rete testis
Prevalence extremely rare
Blood work markers for GCT typically normal
Prognosis poor
Clin. DDx other testicular mass

Adenocarcinoma of the rete testis, also rete testis adenocarcinoma, is a very rare malignant tumour of the paratesticular region/testis.

General

  • Extremely rare[1] - a few dozen cases in the world literature.
  • Typically older men (>60 years old), but reported in younger men with undescended testis.[1]
  • Possible association with diethylstilbestrol - based on non-human data.[2]
  • Prognosis poor[3] - 3-year and 5-year disease-free survival approximately 50% and 15% respectively.[4]

Clinical:

Gross

  • Lesion of the testicular hilum.[1]

Microscopic

Features:

  • Adenocarcinoma:
    • Atypical columnar or cuboidal cells, often with cigar-shaped nuclei.
    • Classically tubular or papillary architecture.[2]
  • Transistion to normal appearing rete testis.[1]

DDx:

Images

  • ART - low mag. (WC)

  • ART - intermed. mag. (WC)

  • ART - high mag. (WC)

  • ART - high mag. (WC)

  • ART - very high mag. (WC)

www:

IHC

Features:[5]

Others:[5]

  • AFP -ve.
  • CD30 -ve.
  • PLAP -ve.
  • CK5/6 -ve.
  • Calretinin -ve.
  • PSA -ve.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Nochomovitz, LE.; Orenstein, JM. (Aug 1984). "Adenocarcinoma of the rete testis. Case report, ultrastructural observations, and clinicopathologic correlates.". Am J Surg Pathol 8 (8): 625-34. PMID 6465420.
  2. ↑ 2.0 2.1 Newbold, RR.; Bullock, BC.; McLachlan, JA. (Dec 1986). "Adenocarcinoma of the rete testis. Diethylstilbestrol-induced lesions of the mouse rete testis.". Am J Pathol 125 (3): 625-8. PMC 1888460. PMID 3799821. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888460/.
  3. ↑ Sogni, F.; Monga, G.; Terrone, C.; Gontero, P. (2008). "Primary adenocarcinoma of the rete testis: diagnostic problems and therapeutic dilemmas.". Scand J Urol Nephrol 42 (1): 83-5. doi:10.1080/00365590701517608. PMID 17853037.
  4. ↑ Sánchez-Chapado, M.; Angulo, JC.; Haas, GP. (Oct 1995). "Adenocarcinoma of the rete testis.". Urology 46 (4): 468-75. doi:10.1016/S0090-4295(99)80257-X. PMID 7571213.
  5. ↑ 5.0 5.1 5.2 Lin, XY.; Yu, JH.; Xu, HT.; Wang, L.; Fan, CF.; Liu, Y.; Wang, EH. (2013). "A case of adenocarcinoma of the rete testis accompanied by focal adenomatous hyperplasia.". Diagn Pathol 8: 105. doi:10.1186/1746-1596-8-105. PMID 23800084.
  6. ↑ Ulbright, TM.; Young, RH. (Nov 2008). "Metastatic carcinoma to the testis: a clinicopathologic analysis of 26 nonincidental cases with emphasis on deceptive features.". Am J Surg Pathol 32 (11): 1683-93. doi:10.1097/PAS.0b013e3181788516. PMID 18769334.
  7. ↑ Yang, Z.; Sheng, C.; Cao, L.; Wang, D.. "Adenocarcinoma of rete testis with widespread liver metastasis.". Can Urol Assoc J 7 (9-10): E654-6. doi:10.5489/cuaj.470. PMID 24409217.
  8. ↑ Tian, Y.; Yao, W.; Yang, L.; Wang, J.; Wazir, R.; Wang, K. (Feb 2014). "Primary adenocarcinoma of the rete testis: A case report and review of the literature.". Oncol Lett 7 (2): 455-457. doi:10.3892/ol.2013.1708. PMID 24396468.
  9. ↑ Wu, CA.; Chen, YH.; Man, KM.; Shen, JL.; Chen, WC. (2011). "Papillary adenocarcinoma of rete testis mimics inflammatory lump: a case report.". Case Rep Urol 2011: 857812. doi:10.1155/2011/857812. PMID 22606627.
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