Testis & paratestis
Ovarian type tumors
Serous cystadenocarcinoma
Author: Swapnil U. Rane, M.D.
Last author update: 1 August 2014
Last staff update: 28 March 2022
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Serous carcinoma [title]
Table of Contents
Terminology | Epidemiology | Sites | Pathophysiology | Clinical features | Diagnosis | Laboratory | Radiology description | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Electron microscopy description | Differential diagnosisCite this page: Rane S. Serous cystadenocarcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisserouspapCA.html. Accessed November 28th, 2024.
Terminology
- Same as ovarian counterpart
Epidemiology
- Mean age 31 years, range 16 to 42 years (Am J Surg Pathol 1995;19:1359, Hum Pathol 1992;23:75) but can be seen in any age group
Sites
- Paratesticular region
- Commonly involves paratesticular soft tissue in testicular - epididymal groove, visceral tunica vaginalis and rete testis
- Rarely is confined to testicular parenchyma
Pathophysiology
- Same as other serous tumors of ovarian type
- Possible origin from Müllerian metaplasia of mesothelial lining, testicular mesothelial inclusions, embryonic Müllerian remnants
Clinical features
- Most patients present with a scrotal mass with hydrocele of 4 - 6 weeks duration
- Less commonly patients present with a hydrocele alone
- Presentation with metastases is uncommon
Diagnosis
- Suspected clinico - radiologically and confirmed histologically
- Clinico - radiological features do not sufficiently distinguish this tumor from other similar tumors in this region, which are more common
Laboratory
- CA125 may be elevated but is not a consistent feature
Radiology description
- USG: commonly a 2.0 - 3.5 cm paratesticular mass, associated with a hydrocele
- If predominantly cystic, may be associated with papillary or solid area at one end
Prognostic factors
- Has high progression rate and commonly has late metastases
Case reports
- 6 year old child with paratesticular papillary serous cystadenocarcinoma (Indian J Pathol Microbiol 2006;49:36)
- 22 year old man with serous papillary adenocarcinoma of rete testis (J Cancer Res Ther 2007;3:37)
- 29 year old man with serous papillary adenocarcinoma of tunica vaginalis with metastasis (Cancer 1991;67:1450)
- 50 year old man with papillary serous carcinoma of tunica vaginalis (Pathol Res Pract 2000;196:781)
Treatment
- Treatment of choice is high inguinal orchidectomy, followed by chemotherapy
- Role of inguinal lymph node dissection is not established
Gross description
- Commonly 1.5 - 3.0 cm
- Solid, whitish tan, poorly circumscribed, often gritty masses involving soft tissue between testis and epididymis, paratesticular soft tissue or visceral tunica vaginalis
- Papillary fronds may be visible in grossly cystic tumors
- Invasive foci are commonly associated with a fibrous reaction
Gross images
Images hosted on other servers:
Intratesticular mass
Microscopic (histologic) description
- Invasive, well formed papillae lined by serous cuboidal or columnar cells with eosinophilic cytoplasm and marked atypia
- Abundant psammoma bodies
- Areas of borderline serous tumor often present and rarely can be the dominant component
- Most tumors have nuclear grade II or III
Microscopic (histologic) images
Images hosted on other servers:
WT1+
Positive stains
- Mucicarmine highlights intracellular neutral mucin
- Cytokeratins, AE 1 / AE3, S100, EMA, BerEP4, LeuM1 (CD15), B72.3
- Variable CEA, PLAP, WT1, CA125
Negative stains
- Mesothelin, thrombomodulin, HBME1, calretinin
Electron microscopy description
- Gland formation with delicate luminal microvilli and cilia
Differential diagnosis
- Borderline serous papillary tumor: no invasion
- Metastatic carcinoma
- Mesothelioma: expresses thrombomodulin, HBME1, calretinin
