Testis and epididymis
Paratesticular tumors
Male adnexal tumor of probable Wolffian origin

Author: Swapnil U. Rane, M.D. (see Authors page)

Revised: 9 June 2017, last major update May 2014

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PubMed Search: Male adnexal tumor probable Wolffian
Cite this page: Male adnexal tumor of probable Wolffian origin. PathologyOutlines.com website. http://pathologyoutlines.com/topic/testisparatest.html. Accessed August 19th, 2017.
Definition / general
Terminology
  • Also called Wolffian hamartoma
  • Sometimes grouped under the broad term of "benign epithelial proliferations"
Epidemiology
  • Extremely rare in men, more common in women
  • Usually presents as a tumor in 4th to 5th decade
Sites
  • Paratesticular location, commonly around the rete testis, epididymis, vas deferens and seminiferous tubules
Pathophysiology and Etiology
  • Tumors are believed to arise from Wolffian duct remnants, although precise etiology is unknown
  • Though the incidence of Wolffian duct remnants is much higher, they are commonly incidental findings on autopsies or surgical specimens
Clinical features
  • Symptoms include pain, difficulty initiating micturition and sexual dysfunction
  • Most tumors are benign
  • Single case of metastases reported (Scand J Urol Nephrol 2009;43:253), although as reported, malignant mesothelioma cannot be excluded
  • Biopsy / surgical excision required for definitive diagnosis
Case reports
Treatment
  • Surgical excision
Gross description
  • 4 - 8 cm, multicystic
  • Distinct from epididymis and vas deferens
Microscopic (histologic) description
  • Unilocular or multicystic mass lined by a single layer of cuboidal to tall columnar epithelium with apical cilia
  • Secretions are commonly seen on apical aspect of cells and in lumen
  • Nuclei are usually bland with little pleomorphism or mitosis
  • Cysts are surrounded by variable connective tissue / fibromuscular stroma
  • Lymphovascular emboli or invasive features are usually absent
Microscopic (histologic) images

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Female Wolffian adnexal tumor

Positive stains
Negative stains
Electron microscopy description
  • Short villi are prominent unlike the long bushy villi of mesothelioma
  • Intraluminal flocullent densities representing secretions and free ribosomes are prominent
  • Mitochondria are sparse
Differential diagnosis