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21st European Congress of Pathology
Istanbul, Turkey, September 08-13, 2007
http://www.ecp2007istanbul.org/
Slide Seminar 17, September 10th
Testicular Non Germ Cell Tumors
Chairperson: G. Mikuz |
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Case 1
Presented by: Zdenka Ovčak
Clinical History
A 69-year old patient with a large hydrocoele on the right side, growing fast in the last three months was admitted to the hospital. A hydrocoelectomy was performed. At surgical procedure a testicular tumor was disclosed, confirmed by frozen section and followed by orchiectomy.
Gross pathology:
The removed testis measured 45 x 20 mm. In the testicular hilus a relatively firm and ill defined whitish tumor, measuring 5 mm was found. Slightly thickened testicular tunica had a smooth surface. The testicular parenchyma appeared normal
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Diagnosis & discussion |
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Case 2
Presented by: Hakan Aydin
Clinical History
31-year-old male presented with a scrotal mass. His past medical history was significant for clear cell renal cell carcinoma (RCC) and von-Hippel Lindau Disease (VHLD).
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Diagnosis & discussion |
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Case 3
Presented by: Kutsal Yorukoglu
Clinical History
The patient was 68 years old. Stage IV prostatic carcinoma was diagnosed 18 months ago. He was put on Ciproterone acetate (Androcur ®) 100 mg t.i.d, and Zolendronic acid (Zometa ®) 4 mg once a month for extensive bone metastasis. He developed deep vein thrombosis, congestive heart failure, and admmitted to our hospital. Bilateral orchiectomy was performed. Bilateral nephrostomy was also performed for obstructive symptoms. Both testes were atrophic, and no mass was apparent, macroscopically.
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Diagnosis & discussion |
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Case 4
Presented by: Ferran Algaba
Clinical History
Twenty two years old man with widespread metastases to the lungs and the left supraclavicular, retroperitoneal, and inguinal lymph nodes. He referred a progressive enlargement of the right testis during the last two months.
A radical orchiectomy was done. In spite of multidrug chemotherapy the patient died 17 months later.
Gross Patthologv: Testicular specimen of 12 x 7 x 6 cm. A multinodular greyish-white, firm mass, 4.5 x 2.5 x 2 cm in diameter, was found in the parietal layer of the tunica vaginalis of the testis, which was covered by multiple smaller and coalescent nodules of similar tissue. The tunica albuginea as well as the underlying testis were free of tumor.
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Diagnosis & discussion |
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Case 5
Presented by: Gregor Mikuz
Clinical History
53 year old man with symptoms of a chronic inflammation of the right epididymis. Because of an unsuccessful therapy a surgical exploration followed by an orchidectomy has been performed.
Gross pathology: Orchidectomy specimen with a normal appearing testis and epididymis.
Between the two organs a cystic tumor ( 2, 5 cm) filled with a serous fluid. Macroscopically the tumor does not shaw any connection with the testis and epididymis.
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Diagnosis & discussion |
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Case 6
Presented by: Maurizio Colecchia
Clinical History
A previous healthy 56-year-old man presented with testicular swelling and pain. Ultrasound examination showed a cm.3 nodule in his right testis. Intercavoaortic, mesenteric and celiac lymphnodes adenopathies were found at ultrasonography of retroperitoneum. Two liver metastases were found. Ultrasonography of neck, standard Rx of neck and chest were unremarkable. The gross examination showed a cm.5x4x3 right testis with a normal funicle: the parenchima contained a cm.3x2x2 white/yellow, hard, nodular tumor without involvement of the tunica albuginea and adnexa. He underwent right orchifunicolectomy. He was followed up with scintigraphy and PET study, and started the octreotide therapy. He never complained carcinoid syndrome. He is alive 5 years after the surgery with persistent foci of disease in retroperitonal lymphnodes and liver.
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Diagnosis & discussion |
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Case 7
Presented by: Gregor Mikuz
Clinical History
2 months old male baby with a sudden enlargement of the right testis. No other symptoms. Alfa fetoprotein in serum in the normal ranges. The clinical diagnosis was “congenital teratoma” and therefore an orchidectomy was carried out.
Gross pathology: The small testis with 3cm in diameter showed a central withish coulored tumor (Ø =1cm) with small cysts on the cut surface.
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Diagnosis & discussion |
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Case 8
Presented by: Eva Comperat
Clinical History
A 38 year old male was explored for a testicular tumor. After orchidectomy, the tumor with a diameter of 6 cm was more or less well delimited and greyish white.
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Diagnosis & discussion |
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Case 9
Presented by: Božo Krušlin
Clinical History
A 42-year-old man with right testicular swelling is presented. The patient observed painless enlargement of the testis during last few months. Tumor markers were negative with no endocrine disturbances. Ultrasound showed hypoechoic, well defined, solid tumor mass up to 5 cm in largest diameter (Figure 1). The results of other examinations (CT scan of the abdomen, chest x-rays) were within normal limits. The patient underwent orchiectomy and testis with spermatic cord was obtained for pathohistologic analysis.
Gross pathology: On cross section the tumor appeared yellowish-white, well circumscribed, encapsulated, firm, with no necrosis. The tumor was up to 5 cm in diameter. Tunica albuginea and spermatic cord were not affected.
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Diagnosis & discussion |
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Case 10
Presented by: John Srigley
Clinical History
A 9-year-old boy was found to have left testicular enlargement. Ultrasound revealed a 1-cm echogenic mass which was thought to be most consistent with teratoma. The patient underwent a left radical orchidectomy.
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Diagnosis & discussion |
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