Adenomatoid tumor of the epididymis

Case contributed by Mr Hani Sayedin

Presentation

Presented with a painless hard right scrotal lump.

Patient Data

Age: 45 years
Gender: Male
Ultrasound

Right testicular mass arises from the tail of the epididymis. a large fairly well-circumscribed heterogeneous mass and showing internal vascularity. Mass measuring 29 x 27 x 24mm.

Case Discussion

Adenomatoid tumors are ~33% of all tumors of the para-testicular region and 60% of benign tumors of the para-testicular region. Adenomatoid tumors of the epididymis usually present in the para-testicular region. A mesothelial origin has been reported and inflammation might play role in the pathogenesis 1. In addition, an intra-testicular origin of adenomatoid tumor has been described  2. They are benign tumors; therefore, local excision is the optimum treatment 3.  

In our case, the patient was treated by local excision. Histopathology examination reported well circumscribed nodule, consisting of tubules, cords or small nests, composed of or lined with columnar or cuboidal cells. These cells consist of moderate to abundant eosinophilic cytoplasm with single to multiple vacuoles and some of the cells exhibit signet ring cell morphology. The cells exhibit positive reaction for Calretinin. The stroma consists of fibrous tissue and thick muscle fibers. The findings are consistent with adenomatoid tumor.

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