Papillary cystadenoma of the epididymis
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| Papillary cystadenoma of the epididymis | |
|---|---|
| Diagnosis in short | |
 Papillary cystadenoma of epididymis. H&E stain. | |
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| |
| LM | cystic spaces with papillae lined by clear cells with moderate cytoplasm |
| LM DDx | serous borderline tumour of the paratestis, adenomatoid tumour, metastatic clear cell carcinoma (esp. clear cell renal cell carcinoma) |
| IHC | AE1/AE3 +ve, EMA +ve, CD10 -ve |
| Gross | solid and/or cystic mass, well-circumscribed |
| Site | epididymis |
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| |
| Syndromes | von Hippel-Lindau disease |
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| |
| Symptoms | +/-scrotal swelling |
| Prevalence | rare |
| Prognosis | benign |
| Clin. DDx | testicular masses - esp. germ cell tumours, paratesticular lesions |
| Treatment | excision |
Papillary cystadenoma of the epididymis is a rare benign epithelial tumour of the epididymis.[1]
Papillary cystadenoma redirects here.
General
- May be associated with von Hippel-Lindau disease.[1]
- Large age range (16-76 years old).[2]
- Typically young adults (median age 30 years old).[2]
Clinical:[2]
- Slow growing scrotal mass or incidental finding.
Gross
- Well-circumscribed mass.
- Solid and/or cystic.
Microscopic
Features:[2]
- Clear cells with moderate cytoplasm and bland nuclear features (no nuclear atypia).
- Often arranged in nests.
- Cystic spaces (often microscopic and macroscopic).
- Papillary structures - may be rare.
DDx:
- Adenomatoid tumour.
- Serous borderline tumour of the paratestis.
- Metastatic clear cell tumours - esp. clear cell renal cell carcinoma.
Images
Case
PCE - very low mag.
PCE - low mag.
PCE - low mag.
PCE - intermed. mag.
PCE - high mag.
PCE - very high mag.
www
IHC
Features:[2]
- AE1/AE3 (7 of 7 cases).
- EMA +ve (9 of 9 cases).
- CK7 +v3 (3 of 3 cases).
- PAX8 +ve (6 of 7 cases[3])
Others:[2]
- Vimentin +ve/-ve (3 of 6 cases +ve).
- CD10 -ve (0 +ve of 5 cases).
- CK20 -ve (0 +ve of 4 cases).
- S100 -ve (1 +ve of 4 cases).
- RCC -ve (0 +ve of 7 cases[3]).
- AMACR -ve (2 weakly +ve of 7 cases[3]).
Note:
- Papillary cystadenoma of the epithymis has an immunoprofile that is nearly identical to clear cell papillary renal cell carcinoma.[3]
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Right Epididymis, Mass, Excision: - Papillary cystadenoma of the epididymis, see comment Comment: The tumour stains as follows: POSITIVE: AE1/AE3, vimentin NEGATIVE: CD10, calretinin, CD68, S100, OCT3/4 Papillary cystadenoma of the epididymis is a benign uncommon tumour. Approximately 60 cases are reported in the literature. It is associated with von Hippel-Lindau disease in approximately 1/3 of cases.
See also
References
- ↑ 1.0 1.1 1.2 Toutziaris, C.; Kampantais, S.; Perdikis, I.; Gourvas, V.; Laskaridis, L.; Gkagkalidis, K.; Lakis, S.; Ioannidis, S. (2013). "Papillary cystadenoma of epididymis: Is there a need for further investigation in unilateral cases?". Int J Surg Case Rep 4 (7): 616-8. doi:10.1016/j.ijscr.2013.03.038. PMID 23708309.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Odrzywolski, KJ.; Mukhopadhyay, S. (Apr 2010). "Papillary cystadenoma of the epididymis.". Arch Pathol Lab Med 134 (4): 630-3. doi:10.1043/1543-2165-134.4.630. PMID 20367315.
- ↑ 3.0 3.1 3.2 3.3 Cox, R.; Vang, R.; Epstein, JI. (May 2014). "Papillary cystadenoma of the epididymis and broad ligament: morphologic and immunohistochemical overlap with clear cell papillary renal cell carcinoma.". Am J Surg Pathol 38 (5): 713-8. doi:10.1097/PAS.0000000000000152. PMID 24441657.