Journal of Pathology and Translational Medicine

Original Article

A Serous Papillary Cystadenoma of Low Malignant Potential in Paratesticular Tissue.: Keum Min Park, Nam Bok Cho, Kye Yong Song; Korean J Pathol. 1996;30(5):463-465.

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Abstract PDF: The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

Case Reports

Granulosa Cell Tumor Arising in the Paratesticular Area: A case report.: Soo Kee Min, Tae Jin Lee, Joo Ryung Huh, Tae Han Park, Jae Yoon Ro; Korean J Pathol. 1999;33(5):380-384.

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Abstract PDF: Granulosa cell tumor of the testis is extremly rare in adult males and granulosa cell tumor occurring in the paratesticular area has not been reported. We report a paratesticular granulosa cell tumor in a 34-year-old man who presented with a 5.5 cm sized scrotal mass. The tumor was present in the paratesticular area near the head of epididymis. It was located in the tunica and completely separated from the testis by thick fibrous tissue. Microscopically, the tumor exhibited solid, microfollicular, and trabecular patterns. The tumor cells had ovoid to elongated nuclei with longitudinal intranuclear grooves and one or two nucleoli and scanty cytoplasm. Mitoses were relatively frequent with an average number of 9/10 HPFs. The tumor extended into the visceral tunica vaginalis and showed multiple lymphatic tumor emboli. Immunohisto chemical stains revealed diffuse strong positivity for inhibin, vimentin, and keratin and diffuse weak positivity for estrogen and progesteron receptor. Placental alkaline phosphatase (PLAP) and epithelial membrane antigen (EMA) were negative. On electron microscopic examination, tumor cells were polygonal and had large indented nuclei. The cytoplasm contained a moderate number of small round mitochondria, abundant rough and smooth endoplasmic reticula, and a few lipid droplets. Small aggregates of intermediate filaments and intercellular junctions were observed. The patient was alive and well 5 months after orchiectomy. This is the first case of adult granulosa cell tumor arising in the paratesticular area.

Inflammatory Pseudotumor of the Paratesticular Area: A Case Report.: Na Rae Kim, Seung Yeon Ha, Jae Gul Chung, Joungho Han; Korean J Pathol. 2004;38(3):208-211.

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Abstract PDF: Inflammatory pseudotumors of the paratesticular area are rare, and are often reported in the literature by various terms, e.g., proliferative funiculitis, inflammatory myofibroblastic tumor, pseudosarcomatous myofibroblastic proliferation and fibrous pseudotumor. This is one of the most common lesions of that region, and typically presents as a longstanding, painless scrotal mass. Here, we describe a 34 year-old man who has had a palpable scrotal mass for the past 10 years. The excised mass was composed of multiple conglomerated nodules, which had homogeneous rubbery cut surfaces. Histologically, each was a well circumscribed, but unencapsulated mass of hyalinized collagenous tissue interspersed with lymphoplasmacytic cells and lymphoid follicle formation. A small fraction of paucicellular spindle cells was positive for vimentin, smooth muscle actin and CD68. Ultrastructurally, abundant collagen fibrils were mixed with paucicellular spindle cells and inflammatory cells. These spindle cells had abundant rough endoplasmic reticula and myofilaments with focal densities, indicating myofibroblastic differentiation.

Fibrous Pseudotumor of Paratesticular Region: A case report.: Hyu Nee Yim, Jong Yup Bae, Dong Hwan Shin; Korean J Pathol. 1994;28(3):332-335.

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Abstract PDF: Fibrous pseudotumor of paratesticular region is rare, but one of the most common neoplasm of that region. It has also been called as nodular fibrous proliferation, pseudofibromatous periorchitis, benign fibrous paratesticular tumor, and fibrous mesothelioma(pseudofibroma). We herein report a case of fibrous pseudotumor with characteristic histological findings. The patient is a 59 year-old male who had incidentally found scrotal mass and undergone radical orchiectomy. There was two separate nodules at tunica vaginalis and proximal spermatic cord which had bulging whitish-gray cut surface with focal myxoid change. Histologically, the mass was composed of dense collagenous tissue with scattered lymphoid follicles and numerous chronic inflammatory cells. There was a proliferation of spindle or stellate shaped cells, some of which featured enlarged hyperchromatic nuclei with prominent nucleoli, and abundant basophilic cytoplasm. These cells stained positive for vimentin and actin immunohistochemically, suggesting that this lesion might derive from proliferation of myofibroblasts.

Buerger's Disease of Paratesticular Tissue: A case report.: Soo Im Choi, So Young Jin, Chan Il Park; Korean J Pathol. 1988;22(4):462-466.

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Abstract PDF: We report a case of Buerger's disease manifested by a scrotal mass, in view of its rarity. A tender bean sized mass was palpated in the left scrotum of a 34 year-old male heavy smoker, who had a history of right pain two years ago which subsided spontaneously. The left testis with the paratesticular tissue was excised. Vessels of the spermatic cord and epididymis showed microscopic changes of Buerger's disease. The involved arteries and veins revealed a predominantly subacute pattern with granulomatous inflammation and Langhans' type giant cells within the thrombi.

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