Testiclular tumor | PathXchange

11/02/2009

Testiclular tumor

California Hospital Medical Center

Tags:

30-year-old male with right testicular tumor.

Procedure: Right radical orchiectomy.

Gross: The specimen consists of a resected pink-tan testicular mass lesion, measuring 10 x 8.5 x 7 cm., and weighing 430 gms. The mass lesion is bivalved. The cut surface reveals a large tumor mass with mucinous material, chocolate old hemorrhage, and multiple small cysts. The testicular tissue is entirely replaced the tumor. Focal calcification is identified. The tunica albuginea is grossly smooth, and not involved. The tunica albuginea is free from the tunica vaginalis. The attached lymphovascular stump (spermatic cord) measures 11 cm. in length with a diameter of 1 cm.

Case Overview
Diagnosis

Age:

Sex:

male

History:

Right testicular tumor.

Note:

Mcro: Sections through the enlarged testicular tumor reveal immature cystic teratoma with multiple cystic lesions lined by ciliated respiratory epithelium with scattered goblet cells (Image 90). Mucinous luminal cystic contents with numerous foamy macrophages are observed. Patchy neural ectodermal small blue cells are present in the cystic wall (Image 89). Areas of poorly formed bony and cartilaginous tissues are identified (Images 87 & 88). Patchy tumor necrosis and hemorrhage are present. The viable tumor cells show high N/C ratio, prominent nucleoli, and clear cytoplasm. Patchy lymphocytic infiltration is co-present with viable tumor cells, morphologically consistent with seminoma (Image 86). Atrophic and fibrotic tubules are present at the periphery of the testis. The tunica albuginea is free of tumor involvement. The spermatic cord resection margin is negative for malignancy. H&E stain.

IHC stains:
Pankeratin (AE1/AE3) - Negative.
EMA - Negative.
AFP - Negative.
hCG - Negative.
PLAP - Positive (highlighting viable and necrotic seminoma component) (Image91).