Paratesticular seminoma: echographic features and histological diagnosis with review of the literature. Issue 3 (7th February 2018)

• Record Type: Journal Article
• Authors: Palicelli, Andrea; Neri, Pierluigi; Marchioro, Giansilvio; De Angelis, Paolo; Bondonno, Gianmarco; Ramponi, Antonio
• Is Part Of: Apmis. Volume 126:Issue 3(2018)
• Page Start: 267
• Page End: 272
• Publication Date: 2018-02-07
• Subjects: Seminoma -- paratesticular -- spermatic cord -- ultrasound -- epididymis; Pathology -- Periodicals; Microbiology -- Periodicals; Immunology -- Periodicals; 572
• DOI: 10.1111/apm.12806
• Languages: English
• ISSNs: 0903-4641

Abstract

Abstract : Primary extratesticular seminomas exceptionally occur in the epididymis or in the paratesticular region/spermatic cord. Some old papers included poor histological description or insufficient photographic documentation, reducing the number of faithful cases: an up‐to‐date systematic review is lacking. We report the 4th primary seminoma of the paratesticular region/spermatic cord in a 35‐year‐old man, including the first echographic description. We provide review of the literature and etiopathogenetic discussion. Ultrasound examination showed a right paratesticular, solid, heterogeneous mass (iso‐hypoechoic with hyperechoic striae; peri‐ and intra‐lesional vascular signals) with no testicular involvement: the paratesticular origin was confirmed by pathological examination. Despite careful gross examination and extensive sampling, the 6.5‐cm extratesticular tumor revealed only one microscopic focus with minimal invasion (<2 mm) of the atrophic testicular parenchyma. Intratubular germ cell neoplasia or morphologic features of a regressed testicular tumor (fibrosis/scar, necrosis, hyalinization, calcification, inflammation) were not found. Primary seminomas of the paratesticular region/spermatic cord occurred at an older mean age and presented as bigger lesions if compared to the 9 primary epididymal seminomas reported in literature. Clinical‐pathological correlation and accurate sampling are mandatory for a correct diagnosis.