A 51-yr-old man presented with an enlarged right testis for two months. The radically resected testis showed a relatively well-circumscribed ovoid mass, nearly replacing the normal architecture with central cystic changes. Microscopically, the mass was composed of ovoid shaped tumor cells of a moderately differentiated squamous cell carcinoma (SCC). The central portion of the mass was filled with well-formed laminated keratinous materials and the remnant cavity lined by dysplastic squamous epithelium, indicated SCC may be derived from an epidermal cyst. SCC is among the most common types of neoplasm afflicting human beings, but it is rare in the testis. To our knowledge, this is the second report of the testicular squamous cell carcinoma occurring in a patient without other primary tumors, and the firstly reported case in Korea.
Carcinoma, Squamous Cell/diagnosis/*pathology ; Humans ; Korea ; Male ; Middle Aged ; Testicular Neoplasms/diagnosis/*pathology

AIMTo study the clinical features of male genital schwannoma.

METHODSFive male patients with genital schwannoma admitted from 1991 to 2000 were reviewed. The lesions were located in the prostate, spermatic cord, testis or penis. Tumors were simply resected in 3 patients and radically eradicated in 2.

RESULTSThe average age of the cohort was 37 years. The most common sign at presentation was a palpable genital mass accidentally discovered by the patient or detected by the physician during a physical check. Diagnosis was made through postoperative pathological examination. Follow-up ranged from 2 years to 6 years (mean 4.5 years). Four cases were cured by simple excision and 1 patient with malignant testis schwannoma died of recurrence 1 year after surgery.

CONCLUSIONOwing to the lack of characteristic clinical manifestation, the final diagnosis relies on postoperative pathological examination. S-100 and vimentin are useful markers for the diagnosis of these tumors.

Adult ; Aged ; Genital Neoplasms, Male ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Neurilemmoma ; diagnosis ; pathology ; Penile Neoplasms ; diagnosis ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology ; Testicular Neoplasms ; diagnosis ; pathology

OBJECTIVETo investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and treatment of primary neuroendocrine tumor (NET) of the testis.

METHODSUsing light microscopy and immunohistochemistry, we studied 7 cases of primary NET of the testis, reviewed relevant literature, and analyzed the clinical manifestations, histomorphologic and immunohistochemical characteristics, treatment and prognosis of the tumor.

RESULTSThe 7 male patients, at the mean age of 40.6 years, all presented with testicular painless masses, none accompanied with carcinoid syndrome. Histologically, the uniform tumor cells were arranged in trabecular, island, solid and/or flake structures and locally in a tubulo glandular pattern, round and polygonal in shape, with a small amount of lipid vacuoles in the eosinophilic cytoplasm. The cells had round nuclei with fine chromatin and rarely identified mitosis. Immunohistochemical staining showed that the tumor cells were positive for Syn, CgA, NSE and CK, with a Ki-67 positive rate of < 2%.

CONCLUSIONPrimary NET of the testis is a rare and low-grade malignancy. Early diagnosis and surgical resection are essential for good prognosis. Immunohistochemistry helps its diagnosis and differential diagnosis from other metastatic neuroendocrine carcinoma, teratomas with carcinoid, seminoma, and Sertoli cell tumor.

Adult ; Carcinoid Tumor ; diagnosis ; pathology ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors ; diagnosis ; pathology ; Prognosis ; Testicular Neoplasms ; diagnosis ; pathology

OBJECTIVETo explore the diagnosis and treatment of testicular intratubular seminoma.

METHODSOne case of testicular intratubular seminoma was diagnosed with testicular biopsy. Epididymal sperm was aspirated and intracytoplasmic sperm injection ( ICSI) was performed. And local radiotherapy was conducted on the bilateral testes after fertilization.

RESULTSThe result of testicular biopsy revealed bilateral testicular intratubular seminoma. Large numbers of sperms were found in the epididymal aspirate. ICSI did not succeed for the first time. The second ICSI succeeded. The local radiotherapy by 60Co had been conducted on the bilateral testes, and testicular tumor didn't develop further.

CONCLUSIONTesticular intratubular seminoma is a type of intratubular germ cell neoplasia, with no clinical manifestations, and usually found in testicular biopsy. Earlier management promises better prognosis.

Adult ; Biopsy ; Humans ; Male ; Seminoma ; diagnosis ; pathology ; therapy ; Sperm Injections, Intracytoplasmic ; Testicular Neoplasms ; diagnosis ; pathology ; therapy ; Testis ; pathology

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent.
Diagnosis, Differential ; Diagnostic Errors ; Humans ; Male ; Middle Aged ; Orchiectomy ; Sparganosis/*diagnosis/pathology/ultrasonography ; Testicular Neoplasms/diagnosis/ultrasonography ; Testis/pathology

PURPOSE: It has generally been accepted that the most common primary testicular tumor in the pediatric population is yolk sac tumor. Recently, there have been some reports that teratoma is the most common tumor in this age group. The histopathological distribution and clinical behavior of primary pediatric testicular tumors from three hospitals were retrospectively reviewed. MATERIALS AND METHODS: A retrospective review was performed on 30 pediatric patients, who had been treated for primary testicular tumors, at three hospitals. The records of the patients were reviewed with respect to age at diagnosis, affected sites, presentation, operation, pathology and prognosis. The mean age of the patients was 68.3 months (1-234). RESULTS: The most common presentation was a painless scrotal mass (86.7%). In patients younger than 15 years, the most common testicular tumor was teratoma at one hospital and yolk sac tumor at the other two hospitals. Totally, the most common testicular tumor was teratoma (52%), followed by yolk sac tumor (40%). In 5 patients, aged 15-20 years, the pathological distribution of the testicular tumor was the same as that observed in adults. No patients had had a recurrence after a mean follow- up of 30.6 months (3-109). CONCLUSIONS: Our results suggest that the prognosis for children with testicular tumors is favorable. The most common primary prepubertal testis tumor is teratoma, followed by yolk sac tumor, although yolk sac tumor was the most common tumor at two of the hospitals in this study. A large prospective multi-center study will be required to determine the pathological distribution of pediatric testicular tumors.
Adult ; Child* ; Diagnosis ; Endodermal Sinus Tumor ; Humans ; Pathology ; Prognosis ; Recurrence ; Retrospective Studies ; Teratoma ; Testicular Neoplasms* ; Testis

OBJECTIVETo study the clinicopathological characteristics, immunohistochemical features and histogenesis of primary testicular carcinoid tumor and its differential diagnosis.

METHODSLight microscopy and immunohistochemical stains were performed in 4 cases of primary testicular carcinoid tumor.

RESULTSThe patients sought care for scrotum mass presented from 2 to 36 years, 2 cases accompanied with tender swelling of the testis. The tumors were described as nodular, yellowish-gray in color, 3.0-4.0 cm in the greatest dimensions, and well circumscribed, focal necrosis seen in 1 case. Histologically, they showed insular and trabecular patterns separated by fine fibrous bands. The tumor cells were round or polygonal with regular monomorphic nuclei, stippling chromatin and eosinophilic granular cytoplasm. There were rosette-like and tubuloglandular patterns with eosinophilic secretion in the cavity. Immunohistochemical staining for synaptophysin, chromogranin A, NSE and cytokeratin showed diffusely positive expression in the tumor cells.

CONCLUSIONPrimary testicular carcinoid tumor is extremely rare with good prognosis and its histogenesis remains controversial. Diagnostically it has to be differentiated from seminoma, metastatic carcinoid tumor, Sertoli cell tumor and granulosa cell tumor.

Adult ; Carcinoid Tumor ; diagnosis ; pathology ; Diagnosis, Differential ; Granulosa Cell Tumor ; pathology ; Humans ; Male ; Neoplasm Metastasis ; Seminoma ; pathology ; Sertoli Cell Tumor ; pathology ; Testicular Neoplasms ; diagnosis ; pathology

Testicular microlithiasis (TM) refers to the calcium deposits within the seminiferous tubules. Owing to the wide use of scrotal ultrasonography, more cases of TM have been diagnosed clinically. TM can be associated with many conditions, including cryptorchidism, infertility, varicocele, testicular torsion, Klinefelter's syndrome, intratubular germ cell neoplasia (IGCN) and testicular germ cell tumor (TGCT), and its frequent association with IGCN, TGCT and infertility is the particular concern of urologists and andrologists. The etiology of TM is not yet certain. Its biological meaning and clinical significance have not been well defined. Currently, there are controversies on the correlation of TM with IGCN, TGCT and infertility. This article reviews the definition, prevalence, etiology, and histopathology of TM, and summarized its association with IGCN, TGCT, and male infertility as well as the management of the disease.
Calculi ; diagnostic imaging ; Germinoma ; diagnostic imaging ; Humans ; Incidence ; Male ; Scrotum ; diagnostic imaging ; Testicular Diseases ; diagnosis ; epidemiology ; pathology ; Testicular Neoplasms ; diagnostic imaging ; Ultrasonography

We report a case of adult granulosa cell tumor arising in the scrotal tunics. The patient was a 34-year-old man who presented with right scrotal swelling, first noticed four months previously. Under the initial clinical impression of epididymo-orchitis, antibiotic treatment was instituted but there was no response. The paratesticular nodules revealed by ultrasound and magnetic resonance imaging mimicked intratesticular lesion, and radical orchiectomy was performed. Although several cases of adult testicular granulosa cell tumor, have been reported, the occurrence of this entity in the paratesticular area has not, as far as we are aware, been previously described.
Adult ; Case Report ; Granulosa Cell Tumor/*diagnosis/surgery ; Human ; Magnetic Resonance Imaging ; Male ; Scrotum/*pathology/*ultrasonography ; Testicular Neoplasms/*diagnosis/surgery

PURPOSE: Testicular microlithiasis (TM) is a relatively rare clinical entity of controversial significance characterized by the existence of hydroxyapatite microliths located in the seminiferous tubules. The aim of this study was to observe the natural course of changes in the calcific density of pediatric TM. MATERIALS AND METHODS: We included a total of 23 TM patients undergoing scrotal ultrasound (US) on at least two occasions from July 1997 to August 2014. We retrospectively analyzed the patient characteristics, clinical manifestations, specific pathological features, and clinical outcomes. We measured the calcified area and compared the calcific density between the initial and final USs. RESULTS: The mean age at diagnosis was 11.3+/-4.6 years, and the follow-up period was 79.1+/-38.8 months (range, 25.4-152.9 months). During the follow-up period, no patients developed testicular cancer. Calcific density on US was increased in the last versus the initial US, but not to a statistically significant degree (3.74%+/-6.0% vs. 3.06%+/-4.38%, respectively, p=0.147). When we defined groups with increased and decreased calcification, we found that diffuse TM was categorized into the increased group to a greater degree than focal TM (10/20 vs. 4/23, respectively, p=0.049). In addition, five of eight cases of cryptorchidism (including two cases of bilateral cryptorchidism) were categorized in the increased calcification group. CONCLUSIONS: Diffuse TM and cryptorchidism tend to increase calcific density. Close observation is therefore recommended for cases of TM combined with cryptorchidism and cases of diffuse TM.
Adolescent ; Calcification, Physiologic ; *Calculi/complications/epidemiology/pathology/physiopathology ; Child ; Cryptorchidism/diagnosis/etiology ; Densitometry/methods ; Follow-Up Studies ; Gonadoblastoma/diagnosis/etiology ; Humans ; Male ; Republic of Korea ; Scrotum/*ultrasonography ; Seminiferous Tubules/*pathology ; *Testicular Diseases/complications/epidemiology/pathology/physiopathology ; *Testicular Neoplasms/diagnosis/epidemiology/etiology