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

Immunoprofile
Ordóñez and associates {1973} examined
one case by immunohistochemistry
and concluded that the so-called
mesothelial cells are histiocytes,
although the originally described lesions
may not represent the same process
{2769}. An analogous proliferation of the
pleura has been encountered and
reported as nodular histiocytic hyperplasia
{401,455}.
Prognosis
The lesion is benign.
Adenocarcinoma of the
epididymis
Fig. 4.102 Carcinoma of the epididymis.
Definition
Adenocarcinoma of the epididymis is a
rare gland forming, malignant neoplasm
derived from epididymal epithelial cells.
ICD-O code 8140/3
Incidence and clinical features
It occurs in men from 27-82 years, mean
age, 67 years. Only 10 well documented
cases have been reported {418,770,833,
1095,1240,1438,2814}. The clinical presentation
is a palpable scrotal mass and/or
testicular pain and frequently a hydrocele.
Macroscopy and histopathology
The tumours are centred in the epididymis
and range from 1.0-7.0 cm. in
greatest dimension with a tan or greywhite
colouration. Foci of haemorrhage
and necrosis may be present.
Epididymal adenocarcinoma may have
tubular, tubulopapillary, papillary or cystic
growth patterns often in combination
{1240}. Tumour cells are columnar or
cuboidal and often contain clear cytoplasm
due to glycogen. The immunohistochemical
profile of these tumours
includes strong reactivity for cytokeratins
(AE1/3) and epithelial membrane antigen.
Staining for CEA, Leu M1, prostate specific
antigen, Leucocyte common antigen
and S100 protein have been reported as
negative {418,833,1240}. Electron microscopic
features include desmosomal
junctions, cilia, glycogen particles and
multivesicular bodies {1240}.
Prognosis
Meaningful follow-up data exists in only 5
patients, three of whom developed
Fig. 4.103 Papillary cystadenoma of the epididymis. Ectatic duct with clear cell lining and colloid-like luminal fluid.
metastases {418,770,833,1240}. The
tumour invades locally and metastatic
spread is to the retroperitoneal lymph
nodes and lungs.
Papillary cystadenoma of
epididymis
Definition
A benign papillary epithelial tumour in
the epididymal ducts.
ICD-O code 8450/0
Incidence
These benign tumours are seen in about
17% of patients with von Hippel-Lindau
disease {1431,2664} but, overall, they
are generally regarded as rare or uncommon
{206,877}.
Clinical feature
These present as asymptomatic nodules
in the region of the head of the epididymis.
They have usually been present
for a number of years and enlarged very
little {1800}. Some have been discovered
during evaluation for infertility, and this
diagnosis should be considered when
azoospermia is associated with an epididymal
mass {2104}. They occur
between 16 and 81 years (mean 36
years) although a few have been seen in
females in the broad ligament and pelvic
cavity {2384}. A few have also occurred
in the spermatic cord {206}. The lesions
have been bilateral in 30-40% of cases.
In von Hippel-Lindau disease they are
more frequently bilateral {287,2111}.
Macroscopy
Grossly, the tumours range from 1.6 to
6.0 cm and are solid or cystic and tan,
270 Tumours of the testis and paratesticular tissue