Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc

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Miscellaneous tumours of the testis F.K. Mostofi I.A. <strong>Sesterhenn</strong> J.R. Srigley H.S. Levin Carcinoid tumour Definition An epithelial tumour of usually monomorphous endocrine cells showing mild or no atypia and growing in the form of solid nests, trabeculae, or pseudoglandulae. ICD-O code 8240/3 Epidemiology The incidence is less than 1% of testicular neoplasms. In the series by Berdjis & Mostofi it accounts for 0.23% {214}. Clinical features The ages range from 10-83 years, with a mean age of 46. Primary carcinoid of the testis usually presents as a mass, and only rarely with carcinoid syndrome {1045}. Symptoms of testicular swelling range from a few months to 20 years {214,766,1938,2569,2923}. Macroscopy The tumours measure between 1.0 cm to 9.5 cm with a mean of 4.6 cm. They are solid, and yellow to dark tan. Calcifications may be present. Histopathology The microscopic appearance is identical to that described in other sites but the trabecular and insular pattern predominate. The larger tumours may show necrosis. Neuroendocrine granules can be identified by electron microscopy {2569,2923}. The cells are positive for endocrine markers (e.g. chromogranin) {1970,2923,2932}. Rarely, primary carcinoids of the testis are malignant metastasizing to lymph nodes, liver, skin and skeletal system {1127,1285,2393,2533}. Carcinoids in teratomas have been included in the category of teratoma with somatic type malignancy {1805}. Carcinoids from other sites (e.g. ileum) can metastasize to the testis {1823}. Tumours of ovarian epithelial types Definition Tumours of testis and adjacent tissues that resemble surface epithelial tumours of the ovary. Incidence These are very rare tumours. Clinical features The patients ages range from 14-68 years. The patients present with scrotal enlargement {2664}. Macroscopy The macroscopic appearance varies with the tumour type. Cystic lesions are usually serous tumours of borderline malignancy or, if mucin is present, mucinous cystadenoma. The more solid tend to be carcinomas {2664,2902}. They may be located in the tunica and paratesticular tissue as well as the testis. Histopathology The histologic appearance is identical to their ovarian counterparts. The reader is referred to the volume dealing with ovarian tumours. Most of the lesions reported in the literature are serous tumours of borderline malignancy {570,2166,2767, 2902}. They also include serous carcinomas {1242}, well differentiated endometrioid adenocarcinoma with squamous differentiation {2902}, mucinous cystadenoma {1295}, and mucinous borderline tumours and cystadenocarcinoma {685,1906}. Differential diagnosis The differential diagnosis includes carcinoma of the rete and mesothelioma. The rete carcinoma should be centered around or in the rete. Immunohistochemistry will be helpful to distinguish mesothelioma from papillary serous tumours. The differential diagnosis of mucinous carcinoma and endometrioid carcinoma should include metastatic adenocarcinoma. A B Fig. 4.84 A Mucinous borderline tumour of the paratesticular tissue. B Endometrioid carcinoma. Miscellaneous tumours of the testis 261
A Fig. 4.85 A, B Brenner tumour of the testis. B Brenner tumour ICD-O code 9000/0 Tumours histologically identical to Brenner tumour of ovary may be encountered in the testis and paratesticular region {312} The age range is 37-70 (mean 57.7) years. Macroscopically, the solid and cystic masses vary from less than1 to 5 cm in diameter. The histology is similar to that of ovarian Brenner tumour with cysts lined by bland transitional Fig. 4.86 Brenner tumour of the testis. epithelium, solid nests of transitional type epithelium and a cellular spindle cell stroma. One mixed Brenner and adenomatoid tumour has been reported {1911}. Most examples of Brenner tumour are benign, although one malignant example showing local invasion, lymphatic space involvement and metastatic deposits in para-aortic lymph nodes has been described {357}. Nephroblastoma ICD-O code 8960/3 Nephroblastoma of testicular adnexa is identical to renal nephroblastoma and is a triphasic tumour comprised of metanephric blastema, epithelial structures consisting of tubular and/or glomerular structures, and mesenchymal structures. Nephroblastomas may occur as a paratesticular tumour {1976} or as a metastasis from a renal nephroblastoma {2303}. Inguinal and scrotal nephroblastomas have occurred in males 3.5 years of age and younger {116}. Paratesticular tumours have been associated with heterotopic renal anlage and one paratesticular nephroblastoma metastasized to the lung {1976}. Primary nephroblastoma has been staged and treated according to NWTS protocol. Paraganglioma ICD-O code 8680/1 In the spermatic cord, these are rare. Five cases have been reported in the literature {605,698,729,2452} and 2 unreported cases are in the Genitourinary Tumour Registry of the Armed Forces Institute of Pathology. They vary in size from 1.5 to 10 cm and are functionally inactive. Histologically, they are indistinguishable from those in other sites. 262 Tumours of the testis and paratesticular tissue
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World Health Organization Classific
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This volume was produced in collabo
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Contents 1 Tumours of the kidney 9
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CHAPTER 1 Tumours of the Kidney Can
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TNM classification of renal cell ca
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one quarter of kidney cancers in bo
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Familial renal cell carcinoma M.J.
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Table 1.02 Genotype - phenotype cor
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A B Fig. 1.11 A Multiple cutaneous
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A B Fig. 1.14 Birt-Hogg-Dubé syndr
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Clear cell renal cell carcinoma D.J
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Fig. 1.20 Clear cell renal cell car
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Papillary renal cell carcinoma B. D
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A B Fig. 1.29 Papillary renal cell
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Fig. 1.33 Chromophobe RCC with sarc
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Carcinoma of the collecting ducts o
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Renal medullary carcinoma C.J. Davi
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Renal carcinomas associated with Xp
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Renal cell carcinoma associated wit
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Papillary adenoma of the kidney J.N
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of this tumour. Microscopic extensi
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A B Fig. 1.59 Metanephric adenoma.
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esults in intratumoral aneurysms. O
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peritumoural fibrous pseudocapsule.
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increases in prevalence to approxim
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Nephrogenic rests and nephroblastom
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Cystic partially differentiated nep
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A B Fig. 1.80 Clear cell sarcoma of
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A B Fig. 1.85 Rhabdoid tumour of th
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transcription factor is fused to th
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Leiomyosarcoma S.M. Bonsib Definiti
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Angiomyolipoma G. Martignoni M.B. A
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melanocytic and smooth muscle marke
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Multinucleated and enlarged ganglio
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Haemangioma P. Tamboli Definition H
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Fig. 1.107 Juxtaglomerular cell tum
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Intrarenal schwannoma I. Alvarado-C
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Mixed epithelial and stromal tumour
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Synovial sarcoma of the kidney J.Y.
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Renal carcinoid tumour L.R. Bégin
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Primitive neuroectodermal tumour (E
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Paraganglioma / Phaeochromocytoma P
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Leukaemia A. Orazi Interstitial inf
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WHO histological classification of
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TNM classification of carcinomas of
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The risk of bladder cancer goes dow
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Tumour spread and staging Urinary b
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feature in such patients undergoing
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A Fig. 2.12 Infiltrative urothelial
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A Fig. 2.15 A Infiltrating urotheli
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A B Fig. 2.19 A Infiltrative urothe
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Fig. 2.23 Infiltrative urothelial c
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ing systems have been proposed on t
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Non-invasive urothelial tumours G.
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chronically inflamed urothelium and
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Inverted papilloma G. Sauter Defini
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muscle invasive disease, but there
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Fig. 2.42 Non-invasive urothelial n
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A Fig. 2.45 Non-invasive urothelial
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for DBCCR1 silencing {984,2476}. Th
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Squamous cell carcinoma D.J. Grigno
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Fig. 2.51 Squamous cell carcinoma.
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Adenocarcinoma A.G. Ayala P. Tambol
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A B Fig. 2.61 A Adenocarcinoma in s
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A B Fig. 2.65 Intramural urachal ca
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Müllerian origin is postulated for
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A Fig. 2.69 Small cell carcinoma. A
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Carcinoid L. Cheng Definition Carci
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Leiomyosarcoma J. Cheville Definiti
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Osteosarcoma L. Guillou Definition
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Leiomyoma J. Cheville Definition A
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Haemangioma L. Cheng Definition Hae
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Metastatic tumours and secondary ex
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Tumours of the renal pelvis and ure
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nodular, ulcerative or infiltrative
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Tumours of the urethra F. Hofstädt
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usually show enteric, colloid or si
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CHAPTER 3X Tumours of of the the Pr
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TNM classification of carcinomas of
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contrast, mortality among migrants
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Fig. 3.06 Transrectal ultrasound of
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PSA-related diagnostic strategies.
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A B C Fig. 3.10 A,B Section of pros
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pale-clear, similar to benign gland
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A B Fig. 3.20 A, B Adenocarcinoma w
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prostate adenocarcinomas exhibit AR
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A Fig. 3.27 A, B Foamy gland adenoc
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A B Fig. 3.32 A Sarcomatoid carcino
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A B Fig. 3.37 A Gleason score 1+1=2
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A B Fig. 3.43 A Prostate cancer Gle
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Fig. 3.48 Heat map-nature. From S.M
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Fig. 3.51 Prostate cancer. Major su
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many stage T1b cancers. Stage T2 Mo
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Fig. 3.58 Patterns of seminal vesic
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Prostatic intraepithelial neoplasia
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A B Fig. 3.63 A Micropapillary high
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A B Fig. 3.68 A Ductal carcinoma in
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Ductal adenocarcinoma X.J. Yang L.
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Papillary pattern can be seen in bo
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A B Fig. 3.74 A Inflammation withou
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Squamous neoplasms T.H. Van der Kwa
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Neuroendocrine tumours P.A. di Sant
Page 205 and 206: Mesenchymal tumours J. Cheville F.
Page 207 and 208: Fig. 3.89 Sarcoma of the prostate.
Page 209 and 210: Miscellaneous tumours P.H. Tan L. C
Page 211 and 212: A Fig. 3.96 A Adenocarcinoma of the
Page 213 and 214: WHO histological classification of
Page 215 and 216: Introduction F.K. Mostofi I.A. Sest
Page 217 and 218: wartime birth cohorts illustrate th
Page 219 and 220: Similar tumours as those of group 1
Page 221 and 222: crucial for the development of this
Page 223 and 224: A B Fig. 4.09 Spermatocytic seminom
Page 225 and 226: A B Fig. 4.14 Intratubular germ cel
Page 227 and 228: A B Fig. 4.19 Seminoma. A Typical s
Page 229 and 230: Fig. 4.24 Seminoma. Vascular invasi
Page 231 and 232: Fig. 4.28 Spermatocytic seminoma wi
Page 233 and 234: A B Fig. 4.33 Embryonal carcinoma.
Page 235 and 236: A B Fig. 4.38 Yolk sac tumour. A En
Page 237 and 238: have cytoplasmic lacunae that conta
Page 239 and 240: A Fig. 4.46 Teratoma. A Longitudina
Page 241 and 242: A B Fig. 4.51 A Cut surface of derm
Page 243 and 244: Fig. 4.54 Mixed germ cell tumour. L
Page 245 and 246: Sex cord / gonadal stromal tumours
Page 247 and 248: A B C Fig. 4.67 Malignant Leydig ce
Page 249 and 250: A Fig. 4.73 A Sertoli cell tumour.
Page 251 and 252: ICD-O codes Granulosa cell tumour 8
Page 253 and 254: ICD-O code 8592/1 Clinical features
Page 255: A B Fig. 4.83 Germ cell-sex cord/go
Page 259 and 260: typical grade III follicular morpho
Page 261 and 262: testicular parenchyma and tumour te
Page 263 and 264: A B the surgical scar and adjacent
Page 265 and 266: Immunoprofile Ordóñez and associa
Page 267 and 268: often have a grey-white cut surface
Page 269 and 270: Fig. 4.111 Angiomyofibroblastoma-li
Page 271 and 272: A B Fig. 4.119 Embryonal rhabdomyos
Page 273 and 274: Table 4.05 Secondary tumours of the
Page 275 and 276: WHO histological classification of
Page 277 and 278: A Fig. 5.04 A, B Squamous cell carc
Page 279 and 280: deformed by an exophytic mass. In s
Page 281 and 282: A B C Fig. 5.12 A Warty (condylomat
Page 283 and 284: A Fig. 5.20 Bowenoid papulosis. A,
Page 285 and 286: three had been circumcized by 9 yea
Page 287 and 288: Mesenchymal tumours J.F. Fetsch M.
Page 289 and 290: Fig. 5.31 Neurofibroma of the penis
Page 291 and 292: oectodermal tumour/Ewing sarcoma [p
Page 293 and 294: Secondary tumours of the penis C.J.
Page 295 and 296: Dr John N. EBLE* Dept. of Pathology
Page 297 and 298: Dr Ricardo PANIAGUA Department of C
Page 299 and 300: Source of charts and photographs 1.
Page 301 and 302: References 1. Anon. (1955). Case re
Page 303 and 304: 115. Ariel I, Sughayer M, Fellig Y,
Page 305 and 306: 246. Birt AR, Hogg GR, Dube WJ (197
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374. Cardone G, Malventi M, Roffi M
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502. Corti B, Carella R, Gabusi E,
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633. Donhuijsen K, Schmidt U, Richt
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768. Fischer J, Palmedo G, von Knob
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900. Goedert JJ, Cote TR, Virgo P,
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1028. Hartmann A, Dietmaier W, Hofs
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1162. Iezzoni JC, Fechner RE, Wong
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1293. Keetch DW, Catalona WJ (1995)
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1424. Ladanyi M, Lui MY, Antonescu
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1548. Lopez-Beltran A, Croghan GA,
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1681. McLaughlin JK, Silverman DT,
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1816. Moudouni SM, En-Nia I, Rioux-
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1945. Ohori M, Wheeler TM, Kattan M
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2070. Phillips G, Kumari-Subaiya S,
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2199. Riou G, Barrois M, Prost S, T
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2327. Schmidt L, Junker K, Weirich
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2450. Smith G, Elton RA, Beynon LL,
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2572. Tamboli P, Mohsin SK, Hailema
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2693. van Echten J, Timmer A, van d
Page 345 and 346:
2816. Wick MR, Berg LC, Hertz MI (1
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2937. Zhuang Z, Park WS, Pack S, Sc
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CCNB, 226 CCND1, 105, 108 CCND2, 22
Page 351 and 352:
J Juvenile type granulosa cell tumo
Page 353 and 354:
Promoter methylation, 21 Prostate s
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Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc

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