Testis and epididymis
Paratesticular tumors
Ovarian epithelial type

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

Revised: 19 July 2017, last major update May 2014

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Ovarian epithelial type testis

Cite this page: Ovarian epithelial type. PathologyOutlines.com website. http://pathologyoutlines.com/topic/testisparatestovarian.html. Accessed November 17th, 2017.
Definition / general
  • Paratesticular tumors resembling ovarian surface epithelial tumors
  • Can be serous, mucinous, endometrioid or Brenner tumor; most common is serous type
  • Can be benign, borderline or malignant, commonly benign or borderline
Terminology
  • Similar to ovarian counterparts
Epidemiology
Sites
  • Paratestis: tunica vaginalis, tunica albuginea, epididymis, rete testis and paratesticular soft tissue
  • May involve testis
Etiology and pathophysiology
  • May arise from Müllerian metaplasia of mesothelium, Müllerian remnants within paratesticular region or testicular embryonic mesothelial inclusions
Clinical features
  • Most common presentation is painless scrotal swelling of varying duration
  • Also chronic swelling with sudden increase in size
Laboratory
  • Normal AFP, HCG and LDH levels help rule out more common germ cell tumors
  • No diagnostic serum marker is known
Radiology description
  • Heterogenous cystic mass
  • Radiological examination is not diagnostic as other benign and malignant cystic lesions are more common
    • Presence of solid nodules / papillary projections within cystic lesions is characteristic of serous tumors though not diagnostic
Radiology images

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Intratesticular scrotal mass

Posterolateral mass

Prognostic factors
  • Not well characterized due to rarity but presence of metastases is single most important factor
  • Most patients reported in literature with nonmetastatic disease have not recurred (mean duration of followup of these cases reported is ~2 years after primary surgery with / without adjuvant chemotherapy); see also Am J Clin Pathol 1986;86:146
  • Two patients with longer followup showed local and distant recurrence 4 and 7 years after primary surgery (Am J Surg Pathol 1995;19:1359)
Case reports
Treatment
  • Radical high inguinal orchidectomy ± adjuvant chemotherapy
Gross description
  • Unilocular or multilocular cyst with serous / mucinous contents
  • Cyst wall shows variable nodularity / papillary projections
  • Calcification may be identified grossly
Gross images

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Intratesticular mass

Microscopic (histologic) description
  • Cystic tumors with ciliated tall columnar epithelium
  • Nuclear atypia and stratification in borderline and malignant cases
  • Psammoma bodies are commonly noted in serous adenocarcinomas
  • Mitoses and apoptosis are common in high grade serous adenocarcinoma
Microscopic (histologic) images

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Papillary projections and psammoma bodies

H&E, CK7, CK20, chromogranin

Positive stains
Negative stains
Differential diagnosis