Genital Neoplasms, Male/surgery* ; Humans ; Male ; Seminal Vesicles/surgery* ; Soft Tissue Neoplasms/pathology*

Objective: To investigate the clinicopathological characteristics, diagnosis, and treatment of primary seminal vesicle adenocarcinoma (SVAC). METHODS: We analyzed the clinical data and clinicopathological characteristics of 4 cases of primary SVAC treated in the Department of Urology of the Second Hospital of Tianjin Medical University and reviewed relevant literature. RESULTS: All the 4 patients were treated by open radical resection of the seminal vesicle and prostate and pathologically diagnosed with SVAC. Preoperative prostatic biopsy had shown 1 of the cases to be negative, while preoperative CT and transrectal ultrasound had revealed a huge pelvic cystic neoplasm in another patient. Immunohistochemistry manifested that the 4 cases were all negative for prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and cytokeratin 20 (CK20), but positive for cancer antigen 125 (CA125) and CK7. All the patients recovered smoothly after surgery and experienced no recurrence or metastasis during 154, 41, 20, and 12 months of follow-up. CONCLUSIONS Primary seminal vesicle carcinoma is extremely rare and presents in an advanced stage. Immunohistochemistry plays a valuable role in its differential diagnosis. Various combinations of radical surgery, radiotherapy, androgen-deprivation therapy, and chemotherapy are recommended for the treatment of the disease.
Adenocarcinoma ; chemistry ; pathology ; surgery ; Biopsy ; CA-125 Antigen ; analysis ; Diagnosis, Differential ; Genital Neoplasms, Male ; chemistry ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Neoplasm Recurrence, Local ; Pelvic Neoplasms ; diagnostic imaging ; Prostate-Specific Antigen ; analysis ; Prostatectomy ; Seminal Vesicles ; pathology ; surgery

Cerebellum ; surgery ; Cystadenoma, Papillary ; complications ; pathology ; surgery ; Epididymis ; pathology ; surgery ; Follow-Up Studies ; Genital Neoplasms, Male ; complications ; pathology ; surgery ; Humans ; Keratin-7 ; metabolism ; Kidney ; surgery ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Vimentin ; metabolism ; von Hippel-Lindau Disease ; complications ; metabolism ; pathology ; surgery

Adult ; Aged ; Breast Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Female ; Gene Amplification ; Genital Neoplasms, Male ; genetics ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary ; genetics ; metabolism ; pathology ; surgery ; Paget's Disease, Mammary ; genetics ; metabolism ; pathology ; surgery ; Penile Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Receptor, ErbB-2 ; genetics ; metabolism ; Scrotum ; Vulvar Neoplasms ; genetics ; metabolism ; pathology ; surgery

OBJECTIVETo study the clinicopathologic characteristics of perivascular epithelioid cell tumor (PEComa), not otherwise specified (NOS) and to evaluate the diagnostic criteria for malignancy.

METHODSThe clinical and pathologic features of 31 cases of PEComa-NOS were reviewed. The follow-up data available were analyzed.

RESULTSThere were a total of 24 females and 7 males. The age of the patients ranged from 13 to 66 years (mean = 40 years). The site of tumor occurrence included gynecologic organs (n = 12), intraabdominal/peritoneal soft tissue (n = 10), gastrointestinal tract (n = 4), thigh (n = 2), mediastinum (n = 1), left groin (n = 1) and urinary bladder (n = 1). None of the cases was associated with tuberous sclerosis complex. Histologic examination showed that 23 cases (74%) were clear cell sugar tumor-like, 4 cases (13%) were clear cell myomelanocytic tumor-like and 4 cases (13%) were of mixed epithelioid-spindled morphology. According to the classification system proposed by Folpe et al, 19 cases (61%) were classified as malignant, 7 cases (23%) as PEComa of uncertain malignant potential and 5 cases (16%) as benign. The expression rates of HMB45, smooth muscle actin and desmin in tested cases were 100% (31/31), 67% (14/21) and 6/18, respectively. Follow-up data (1 to 56 months) were available in 23 cases (74%). Amongst the 16 cases of malignant PEComa, 7 patients were still alive with no evidence of disease, 6 patients were alive with unresectable or recurrent/metastatic disease and 3 patients died of the disease. The local recurrence and metastasis in those 16 cases were 6 cases and 5 cases, respectively. One of the 4 patients with PEComa of uncertain malignant potential died, while the remaining 3 patients and all of the patients with benign PEComa had an uneventful clinical course.

CONCLUSIONSThe classification system of PEComas proposed by Folpe et al. is reliable in routine practice. Correlation with the clinical and radiologic findings however is prudent when dealing with core biopsy specimens or sampling from exploration laparotomy. Owing to the histologic heterogeneity of this entity, thorough understanding of the morphologic spectrum is essential in arriving at a correct diagnosis.

Abdominal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Actins ; metabolism ; Adolescent ; Adult ; Aged ; Desmin ; metabolism ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Genital Neoplasms, Female ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Melanoma-Specific Antigens ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Perivascular Epithelioid Cell Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Prognosis ; Young Adult

Adenocarcinoma ; drug therapy ; pathology ; surgery ; CA-125 Antigen ; metabolism ; Chemotherapy, Adjuvant ; Diagnosis, Differential ; Genital Neoplasms, Male ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Keratin-7 ; metabolism ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Membrane Proteins ; metabolism ; Mucin-1 ; metabolism ; Neprilysin ; metabolism ; Seminal Vesicles ; pathology ; Young Adult

OBJECTIVETo study the clinicopathologic features and histogenesis of calcifying fibrous tumor (CFT).

METHODSThe clinical manifestations, histopathologic characteristics and immunophenotype were analyzed in 11 cases of CFT.

RESULTSThe male-to-female ratio was 5:6, with a mean age of 38 years and age range of 25 to 52 years. The sites of involvement included abdominopelvic cavity (n=6), soft tissue (n=4) and scrotum (n=1). Most patients presented with a gradually enlarging and painless mass. Nearly half of the cases were associated with other diseases or history of inflammation, trauma or surgical intervention. One third of the tumors represented incidental findings and showed no recurrence after resection. Imaging revealed a solitary solid soft tissue mass or multiple nodules with clear borders and associated high-density calcifications. Macroscopically, the tumors were well-circumscribed but non-encapsulated. They ranged from 0.5 to 20.0 cm in diameter and were tan-greyish, round to oval, lobulated or irregular and solid with rubbery consistency. The cut surface was whitish to tan-yellowish, gritty and showed scattered spotty yellowish discoloration corresponding to the foci of dystrophic calcifications. Histologically, CFT was composed of hyalinized fibrous tissue and thickened vessel walls with interspersed bland spindly fibroblastic cells, scattered psammomatous calcifications, dystrophic calcification and lymphoplasmacytic infiltration. In addition, focal cloak-like polymorph infiltration at the tumor periphery and entrapment of adipocytes and nerves were demonstrated in some cases. Foci resembling solitary fibrous tumor, fibromatosis, keloid or inflammatory myofibroblastic tumor were observed. Immunohistochemical study showed that the tumor cells were diffusely positive for vimentin and focally positive for CD34, factor VIII-related antigen and beta-catenin. The admixed plasma cells were notably IgG positive, with more than 50% being IgG4 positive.

CONCLUSIONSCFT has characteristic histopathologic manifestations and shows morphologic and immunohistochemical overlaps with known IgG4-related sclerosing diseases. It is possible that CFT may represent another example of IgG4-related diseases. It often runs a benign clinical course, with rare recurrence after surgical resection. Previous inflammation and trauma may be the precipitating factors of CFT.

Abdominal Neoplasms ; metabolism ; pathology ; surgery ; Adult ; Antigens, CD34 ; metabolism ; Calcinosis ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Genital Neoplasms, Male ; metabolism ; pathology ; surgery ; Humans ; Immunoglobulin G ; metabolism ; Incidental Findings ; Male ; Middle Aged ; Neoplasms, Fibrous Tissue ; metabolism ; pathology ; surgery ; Pelvic Neoplasms ; metabolism ; pathology ; surgery ; Retrospective Studies ; Scrotum ; pathology ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; beta Catenin ; metabolism ; von Willebrand Factor ; metabolism

Diagnosis, Differential ; Genital Neoplasms, Male ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasms, Glandular and Epithelial ; metabolism ; pathology ; surgery ; Neprilysin ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Seminal Vesicles ; Stromal Cells ; pathology ; Vimentin ; metabolism

OBJECTIVETo explore the clinical manifestation, management, recurrence factors and prognosis of scrotal Paget's disease.

METHODSWe retrospectively analyzed the clinical and pathological data of 23 cases of scrotal Paget's disease diagnosed and treated in our hospital from 1996 to 2008.

RESULTSThe disease was confined to one side of the scrotum in 15, and involved the whole scrotum and penis in 8 of the cases. Three patients showed enlarged inguinal lymph nodes in the same side, and 2 in both sides. All the cases were confirmed by biopsy and treated by surgery. Post-operative follow-up was conducted for 2-68 months, which revealed 5 cases of local recurrence and 1 case of death for systemic metastasis.

CONCLUSIONBiopsy is proved to be important for the early diagnosis of scrotal Paget's disease, and extended excision of local lesion is a preferred management.

Aged ; Genital Neoplasms, Male ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Scrotum ; pathology

Primary adenocarcinoma of the seminal vesicles is a rare neoplasm. Congenital seminal vesicle cysts are commonly associated with unilateral renal agenesis or dysgenesis. To the best of our knowledge, mucinous adenocarcinoma of the seminal vesicle cyst that's associated with an ectopic ureter opening into the seminal vesicle and ipsilateral renal agenesis has not been described in the radiological literature. We report here on the radiological findings of a primary adenocarcinoma of a seminal vesicle cyst in this condition.
Adenocarcinoma, Mucinous/complications/*pathology/surgery ; Adult ; Cysts/congenital/*pathology ; Genital Neoplasms, Male/complications/*pathology ; Humans ; Kidney/*abnormalities ; Magnetic Resonance Imaging ; Male ; Seminal Vesicles/*pathology/surgery ; Tomography, X-Ray Computed ; Ureter/*abnormalities