Primary adenomatoid tumor of the testis: report of a case and review of literature.

Adenomatoid tumor (AT) is an extremely rare benign tumor in the testis of infants. A case of 14-month-old boy with testicular adenomatoid tumor was reported in this study. On physical examination, a smooth solid nodule sized 8 mm could be palpated with little tenderness on the head of the right testis. It could be clearly revealed by B ultrasonic scanning and computerized tomography. The patient underwent right radical orchiectomy. In postoperative histopathological study, the tumor was characterized by diffuse sheets of epithelioid cell and desmo-stroma structures. There was positive immunohistochemical staining of mesothelioma-associated antigens. The tumor should be differentiated from the tumor of the male genital tract including benign and malignant tumors of both epithelial and stromal origin. And we followed the case and no nodule was found in his scrotum by physical examination and scrotal ultrasonography after 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, 60 months. These findings have important implications that the histogenesis of adenomatoid tumor of the testis is unclear yet. The diagnosis depends on pathologic studies, and should be differentiated from paratesticular malignant mesothelioma and sclerosed lipogranuloma. Radical surgery is the common choice, and as a result of getting a good prognosis.

Mesothelioma of the tunica vaginalis testis with prominent adenomatoid features: a case report.

Malignant mesotheliomas of the testis arise from the tunica vaginalis, formed from the evagination of the abdominal peritoneum into the scrotum. It is an extremely rare tumor representing 0.3% to 5% of all malignant mesotheliomas. We presented an interesting case of 68-year-old male with swelling and slightly painful in the right scrotum. Histologically, the lesion were composed of small tubular, microcystic, gland lined by flattened epithelioid cells and vague signet ring cells set in a myxofibrous stroma, which is resemblance to adenomatoid tumor. But the tumor cells showed significant atypical cytologic morphology and invaded into spermatic cord tissue, which indicated the diagnosis of malignant tumor. Immunohistochemistry study showed positive expression of CK, CK5/6, CK7, Calretinin, D2-40 and Vimentin which indicated the diagnosis of malignant mesothelioma. This case of mesothelioma should be classified as epithelial in type. To our knowledge, the mesothelioma of the tunica vaginalis testis with adenomatoid tumor-like microscopic features is very rare.

Adenomatoid tumor of the testis in a child.

Adenomatoid tumors are rare benign neoplasms thought to be of mesothelial origin. Although most reported cases arise from the epididymis, rare cases have been reported in the spermatic cord, testicular tunica, ejaculatory ducts, prostate, and suprarenal recess. We describe a 4.5-year-old boy who presented with a relatively asymptomatic right testicular mass that was resected and confirmed to be adenomatoid tumor of the testis by histopathology. Because of its rarity, the clinical and histopathologic aspects are discussed.

[Paratesticular adenomatoid tumor: a report of nine cases]. / Tumor adenomatoide paratesticular: una serie de nueve casos.

INTRODUCTION: Paratesticular tumors are rare. Most of them are benign, and adenomatoid tumors are most common. These tumors sometimes infiltrate the testicular parenchyma and require differential diagnosis with malignant tumors. In such cases, intraoperative biopsy allows for performing conservative surgery. MATERIALS AND METHODS: A retrospective study of nine patients with paratesticular adenomatoid tumors seen during a nine-year period (2000-2008) is reported. RESULTS AND CONCLUSIONS: Patient age (mean, 49.6 years) and most common initial signs (tender nodule) are reported. The tumor most commonly occurred as a small, usually oval, nodule in the tail of epididymis. Our series included a case each of intraparenchymal tumor of the testis and tumor of the tunica vaginalis. Diagnosis was initially made based on a ultrasound scan and subsequently confirmed by histology. Differential diagnosis and surgical treatment, performed in all patients, are reported, and also the pathological features of surgical specimens.

Optical spectroscopy of parotid gland in case of adenopathy.

Reflectance and laser induced fluorescence spectroscopies were employed for the first time in a limited pilot study to probe freshly excised human parotid tissues (adenomatous and adjacent). In human parotid tissue, measurements were associated with endogenous fluorophores NADH and collagen, as well as tissue optical properties, with larger relative collagen content detected from normal to adenomatous tissues. The observed significant differences between the fluorescence and reflectance properties of normal, and adenomatous tissues present an opportunity for future statistical validation on a larger patient pool and indicate a potential application of multimodal optical spectroscopy to differentiate between pathological and normal parotid tissue states at different stages of disease.

[Adenomatoid tumor of the adrenal gland. Case report and review of the literature]. / A mellékvese adenomatoid tumora, avagy irodalmi barangolás egy igen ritka mesothelialis daganat nyomán.

Adenomatoid tumors of the adrenal gland are rather rare, asymptomatic neoplasias with benign behavior and usually are diagnosed incidentally. The authors report a case of an adenomatoid tumor of the right adrenal gland in a 32-year-old man who sought evaluation because of fever and renal pain. During investigation a tumor, localized in right adrenal gland, was identified by ultrasonography and CT. The patient underwent adrenalectomy with histopathological and immunohistochemical diagnosis of adenomatoid tumor of the adrenal gland. Based on literature data the epidemiology, symptoms, differential diagnosis, treatments, histopathology and prognosis of adenomatoid tumors of the adrenal gland are discussed.

Expression of claudins 1, 4, 5, and 7 in ovarian tumors of diverse types.

In this study, 60 different types of ovarian lesions, mainly consisting of ovarian neoplasms, were studied for the expression of claudins 1, 4, 5, and 7. Strong expression of claudins 1, 4, and 7 was seen in benign and malignant epithelial ovarian tumors. Expression of claudin 5, reported to be mainly present in endothelial cells, was seen in ovarian epithelial tumors, but with a significantly lower frequency than claudins 1, 4, and 7. On the contrary, sex-cord stromal tumors and cysts, such as fibromas/thecomas, Sertoli-Leydig cell tumors, granulosa cell tumors, and follicular and luteinized cysts were mainly negative for claudins 1, 4, 5, and 7. Interestingly, adenomatoid tumors did not express claudin 5, which is in agreement with their non-endothelial nature. They were also negative for claudin 4, but expressed claudins 1 and 7, but to a lesser degree than epithelial lesions. In immature teratomas, the epithelial component was usually positive whereas other components were negative for these claudins. Dysgerminomas did not express any of the claudins studied. The results show that claudins 1, 4, and 7 are mainly expressed in ovarian epithelial tumors and can thus be used to indicate epithelial differentiation in them. Eventhough considered an endothelial marker, claudin 5 was also present in a subset of epithelial lesions. However, this claudin can be used to differentiate adenomatoid tumors from vascular lesions. No significant difference was seen between epithelial benign and malignant lesions, except for claudin 5, which seemed stronger in malignant epithelial tumors.

[Adenomatoid tumor]. / Tumore adenomatoide.

Adenomatoid tumour is a neoplastic process of discussed origin, but the immunohistochemical phenotype leads a mesothelial derivation. The preferential site of origin is the genital apparatus of both sexes, however extragenital cases have been described. The histological pattern varies from tubular formation, to solid growth, to cystic areas. In the present report we described a case of Adenomatoid tumour of the uterus body in a 46 years old patient.

Adenomatoid of the adrenal gland.

Adenomatoid tumors are common in the genital tract but rare in the adrenal gland. These tumors can be difficult to diagnose when present in extragenital sites. This type of adrenal tumor lacks specific radiographic features and can be confused preoperatively with more common adrenal gland tumors. We present the case of a 54-year-old man with an incidental right adrenal mass with calcified components and elevated urinary levels of homovanillic acid that was found to be an adenomatoid tumor of the adrenal gland.

[An unusual tumor of the adrenal gland]. / Une tumeur inhabituelle de la surrénale.

Adenomatoid tumors are benign mesothelial tumors that usually affect the genital tract. We report the case of a 65-year-old man with an adenomatoid tumor of the adrenal gland. This uncommon location and its histological heterogeneity can lead to a mistaken diagnosis of malignant tumor. Positive cells with mesothelial markers in immunohistochemistry improve diagnosis. The proper identification of this benign tumor in the adrenal gland and the knowledge of its differential diagnosis deserve attention to avoid invasive treatment.

OCT4 staining in testicular tumors: a sensitive and specific marker for seminoma and embryonal carcinoma.

OCT4 (POU5F1) is a transcription factor expressed in embryonic stem and germ cells and is involved in the regulation and maintenance of pluripotency. It has been detected in primary testicular germ cell tumors with pluripotent potential, seminoma, and embryonal carcinoma. We undertook immunohistochemical staining of OCT4 in a wide variety of primary testicular neoplasms (germ cell tumors and other tumors) to assess the specificity and usefulness of this marker as a diagnostic tool. We examined histologic sections from 91 primary testicular neoplasms, including 64 cases of mixed germ cell tumors containing embryonal carcinoma (54), seminoma (51), yolk sac tumor (38), mature teratoma (31), immature teratoma (20), and choriocarcinoma (15). In addition, we examined sections from spermatocytic seminomas (5), Leydig cell tumors (8), Sertoli cell tumors (6), unclassified sex-cord stromal tumors (4), adenomatoid tumors (2), testicular tumor of adrenogenital syndrome (1), and granulosa cell tumor (1). Each tumor was examined with hematoxylin and eosin staining and with antibodies to OCT4. In all cases of mixed germ cell tumor with components of embryonal carcinoma (54) and seminoma (51), there was greater than 90% nuclear staining of the embryonal carcinoma and seminoma tumor cells with little to no background staining. In all but 1 of these cases (embryonal carcinoma), there was strong (3+) staining intensity. The other germ cell tumor components (yolk sac tumor, mature teratoma, immature teratoma, and choriocarcinoma) showed no staining. Syncytiotrophoblast cells, which were present in 15 of the cases, were also completely negative, as were all 5 of the spermatocytic seminomas. The 22 cases of non-germ cell tumors were all immunohistochemically negative for OCT4. Fifteen of the 54 germ cell tumors containing embryonal carcinoma were also examined with antibodies to CD30. These embryonal carcinoma components were all positive for CD30 with staining of greater than 90% of the tumor cells but with variable staining intensity. We conclude that immunostaining with antibodies to OCT4 is a useful diagnostic tool in the identification of primary testicular embryonal carcinomas and "usual," but not spermatocytic, seminomas. OCT4 immunostaining has comparable sensitivity but greater consistency compared with CD30 in the diagnosis of embryonal carcinoma.

Adenomatoid tumor of the genital tract: evidence of mesenchymal cell origin.

The objective of this study was to re-examine the histogenesis of adenomatoid tumors. This benign neoplasm is characterized by gland-like structures with a pseudodinfiltrative pattern, usually involving fibromuscular tissue at a certain distance from an overlying surface mesothelium. Twenty cases of adenomatoid tumors and four cases of reactive submesothelial lesions, characterized by marked proliferation of subserosal mesenchymal cells, were reviewed. Nineteen of twenty adenomatoid tumors, including lesions with ill-defined borders, showed no connection with surface mesothelium. At the periphery of small tumors, isolated glands, clusters of epithelioid cells and single epithelioid, and spindled cells showing no connection to adjacent glands or cell clusters were identified. The tumor cells shared features with reactive subserosal stromal cells including an infiltrative pattern and histochemical and immunohistochemical properties. The differences between adenomatoid tumors and reactive submesothelial tissue are quantitative in nature: predominant amount of spindled cells in reactive submesothelial lesions, and predominant amount of gland-like structures in adenomatoid tumors. It is proposed that adenomatoid tumors arise from pluripotent mesenchymal cells that differentiate toward submesothelial cells and eventually mesothelial cells. This differentiation is probably induced by the adjacent submesothelial cells.

Immunohistochemical evidence of the mesothelial histogenesis of a uterine adenomatoid tumor.

We present rare case of a uterine adenomatoid tumor. In order to characterize the diversity of immunoreactive antigens associated with mesothelial differentiation, we immunohistochemically examined the tumor's epithelioid and myofibromatoid components, as well as the biphasic pattern of its adenomatoid changes. Immunostaining of tumor cells was positive for high- and low-molecular-weight cytokeratins and vimentin. Specific immunoreactions with antibodies against desmin, alpha-actin, and the S-100 protein also were observed. The present adenomatoid tumor can be explained in terms of various transformations and typical alterations in mesothelioma cells: (1) the mesothelial cells had differentiated to epithelial and stromal components, concomitant with the presence of predominant reactive foci; (2) intermediate cells expressed different types of cytoskeletal intermediate filament proteins (IMPs); and (3) the patterns of fibromatoid and leiomyoid differentiation resembled those of a benign mesothelioma of the ovarian or oviductal peritoneum. Our immunohistochemical investigations indicated that the present tumor exhibited the histogenesis of a true mesothelioma, an adenomatoid mesothelioma.

Adenomatoid tumor of the heart: report of a case.

We report a case of an adenomatoid tumor involving the heart. The lesion was found incidentally at the time of cardiac surgery, measured 1.0 cm, and was poorly demarcated from the adjacent myocardium. Microscopically, the tumor consisted of aggregates of relatively large, epithelioid cells that coalesced to form tubular spaces and occasionally branched into anastomosing channels. The neoplastic cells were strongly immunoreactive with antibodies against cytokeratin. The pathologic features of this unusual cardiac tumor are diagnostic of an adenomatoid tumor, a relatively rare benign neoplasm of mesothelial origin usually found in association with the genital tract. Although rare cases of adenomatoid tumors found outside of the genital tract have been described, including two recently reported pleural tumors, it has not been described to involve the heart.

Adenomatoid tumor of the adrenal gland: a report of four new cases and a review of the literature.

Adenomatoid tumors of the adrenal gland are rare, benign, asymptomatic neoplasms that are usually found incidentally. Previously reported cases occurred only in men and only on the left side. We report four cases, including two from the right adrenal gland, one from a woman, and one with a cystic component. The average age of our patients was 49 years, compared with the average age of 34 years in previously reported cases. Our immunohistochemical stains and electron microscopic analysis support the presumed mesothelial derivation of these tumors. The differential diagnosis of adenomatoid tumors of the adrenal gland includes a variety of solid and cystic tumors. It is important to recognize these rare tumors to avoid misclassifying them, especially as metastatic or primary malignant vascular tumors.