Burned-out tumour of the testis presenting as retroperitoneal choriocarcinoma

A case of “burned-out” tumour of the testis in a 20-year-old man is reported. The tumour presented as widespread retroperitoneal metastases. Orchiectomy displayed a subalbugineal fibrous scar close to the rete testis. Diagnostic biopsy of the unresectable retroperitoneal tumour showed a choriocarcinoma. Although appropriate chemotherapy was promptly started, the patient died 7 months after the initial complaints.     

Adenocarcinoma of rete testisrole of inguinal orchiectomy plus retroperitoneal lymph node dissection

Adenocarcinoma of the rete testis is diagnosed rarely. We describe the clinical and pathologic findings in a forty-seven-year-old man with this unusual tumor. Treatment modalities are reviewed emphasizing the role of radical orchiectomy and retroperitoneal lymph node dissection.     

Cystadenocarcinoma of the rete testis

We report a rare case of primary adenocarcinoma of the rete testis. The stage A lesion was managed successfully with orchiectomy and retroperitoneal lymph node dissection. The histopathological features, treatment and prognosis of this unusual malignancy are reviewed.     

Papillary carcinoma of rete testis

A case of a rare papillary adenocarcinoma of the rete testis (or epididymis) with a solitary metastasis to a periaortic lymph node is reported. The favorable outcome over a three and one-third-year period after radical orchiectomy and retroperitoneal lymphadenectomy has been observed. We believe this is the first report of such a tumor being treated with lymphadenectomy.     

Rete-testis-Karzinom mit lymphogener Metastasierung

Cancers of the rete testis are uncommon and usually occur in the 6th or 7th decade of life. The prognosis is dreadful. Approx. 40% of the affected patients die within 1 year after diagnosis due to progression of the disease. The primary therapy is surgical. Until now there is no effective chemotherapy. In our case following primary inguinal orchiectomy and confirmation of the diagnosis, a radical retroperitoneal lymphadenectomy and wide local resection were performed. One positive lymph node was found and adjuvant radiotherapy was performed. In this case preoperative PET/CT was not helpful. For the last 3 years now the patient has been disease free. Since cancers of the rete testis are very rare and the literature is scarce, we would like to recommend the introduction of a national registry.     

The role of ultrasonographically guided puncture of the human rete testis in the therapeutic management of nonobstructive azoospermia

We attempted to characterize the cells collected from the rete testis via ultrasonographically guided puncture. Unilateral puncture of the rete testis was performed in nine men with obstructive azoospermia and 51 men with nonobstructive azoospermia. All the aspirated samples from the rete testis were observed via confocal scanning laser microscope and some of them after fluorescent in situ hybridization techniques. Then therapeutic testicular biopsy was performed in the punctured testis of each man. Spermatozoa were found in all rete testis samples and all biopsy samples from obstructed men. Twenty-two nonobstructed men demonstrated absence of spermatozoa in biopsy samples. Twenty-nine nonobstructed men showed spermatozoa in biopsy material and 24 of these men (82%) had demonstrated spermatozoa in rete testis samples. There were no significant differences in fertilization and cleavage rate between intracytoplasmic sperm injection trials using biopsy spermatozoa and rete testis spermatozoa both in obstructed and nonobstructed men. Considering that puncture of the rete testis does not reduce the volume of testicular parenchyma, is less invasive and apparently causes less detrimental effect on testicular vasculature than biopsy, puncture of rete testis is recommended as first line approach for the treatment of azoospermic men. If puncture is negative for spermatozoa in nonobstructed men, biopsy is indicated.     

Adenocarcinoma of rete testis

We report a case of adenocarcinoma of rete testis in 64-year-old man. His first diagnosis was hydrocele of left testis, but aspiration cytology showed malignancy. The patient underwent left orchiectomy. The pathological diagnosis was adenocarcinoma of the rete testis. The cancer was suspected to be arising from the duct of rete testis on the histological examination, and no other malignancy was found elsewhere in his body. However, he died at 10 months after the operation for lung metastasis. Adenocarcinoma of rete testis is one of the rarest malignancies. Only 25 cases have been reported since the first case was described by Feek and Hunter in 1945. This is the twenty-sixth case in the literature.     

Primary adenocarcinoma of the rete testis

We report a case of adenocarcinoma of the rete testis in a 44-year-old man, presented intially with a hydrocele and later with signs of infection in the affected hemiscrotum. Multiple focal lesions within the testis appeared 6 months later in ultrasounds. After high inguinal orchiectomy, histology revealed a primary adenocarcinoma of the rete testis. Adenocarcinoma of the rete testis is a rare a highly malignant tumour originating in the mediastinum of the testis. Slightly over 40 cases have been reported in the literature. The treatment of choice is radical orchiectomy. Prognosis is poor; as mainly as 40% of patients die within the first year of diagnosis.     

Papillary adenocarcinoma of rete testis. Autopsy findings, histochemistry, immunohistochemistry, ultrastructure, and clinical correlations

Adenocarcinoma of the rete testis is a rare neoplasm that usually occurs in men after the age of 60 and carries a variable prognosis. We report an occurrence of this tumor in a 91-year-old man who had been treated for 2 years for an hydrocele. At the time of diagnosis, metastases were not evident; and the patient was treated with local radiotherapy. The diagnosis of papillary adenocarcinoma of the rete testis was made on the basis of: (a) a transition from normal rete testis to atypical and neoplastic rete epithelium; (b) exclusion of primary germinal and nongerminal testicular tumors and spread from distant sources; and (c) electron-microscopic findings, histochemical and immunological studies, and autopsy findings supporting the diagnosis. This is the first reported case of adenocarcinoma of the rete testis that includes documentation of the tumor's metastatic pattern.     

Adenocarcinoma of rete testis.

Adenocarcinoma of the rete testis is a rare tumor of the genital tract. An advanced case of adenocarcinoma thought to arise from the rete testis is presented. We believe this is the eighteenth reported case.     

睾丸网管状扩张的彩色多普勒超声诊断

目的 :应用彩色多普勒超声诊断睾丸网管状扩张。　方法 :应用彩色多普勒超声 ,对睾丸网管状扩张的二维图像、彩色多普勒血流图 (CDFI)和脉冲多普勒 (PW)进行了描述。　结果 :睾丸网管状扩张有特征性的彩色多普勒超声图像 (二维图像、CDFI和DW)即无相关的睾丸和邻近组织的病变以及在睾丸内扩张的网管内无血流显示。　结论 :彩色多普勒超声是诊断睾丸网管状扩张的首选影像检查方法。     

Adenocarcinoma of the rete testis. Case report, ultrastructural observations, and clinicopathologic correlates

Adenocarcinoma of the rete testis is a rare tumor that tends to occur in men over the age of 60 and is usually associated with a poor prognosis. We report such a tumor occurring in a 63-year-old male 2 years after he underwent a scrotal exploration in the management of a hydrocele, varicocele, and inguinal hernia. The postorchidectomy course was characterized by slowly advancing, painful scrotal and perineal skin recurrences, lymph node metastases, and the absence of response to Adriamycin and electron-beam therapy. We are confident that the lesion is a carcinoma of the rete testis because: 1) the tumor is situated mainly in the testicular mediastinum, 2) primary germinal and nongerminal testicular tumors and spread from distant sources have been excluded, 3) a transition from normal rete testis to atypical and neoplastic rete epithelium is demonstrable, and 4) the transmission electron-microscopic findings support our conclusion. The distinction between carcinoma of the rete testis and malignant mesothelioma may be difficult and requires consideration of the gross, light-microscopic, and ultrastructural tumor characteristics in optimally fixed tissue.     

Rete testis hyperplasia with hyaline globule formation. A lesion simulating yolk sac tumor.

The presence of eosinophilic, hyaline globules in association with epithelial hyperplasia was noted in the rete testis of three patients with germ cell tumors. In the more florid examples, this proliferation formed a solid and microcystic pattern that, in association with the hyaline globules, mimicked a yolk sac tumor component. However, the bland cytologic features of the cells and the conformation to the configuration of the rete testis were keys to its reactive nature. A subsequent review of 48 testicular specimens containing well-defined areas of the rete testis showed hyaline globule formation in the rete testis or tubuli recti in 16 of 27 germ cell tumors, one of five other testicular tumors (four stromal tumors and one plasmacytoma), and none of 16 nonneoplastic cases. Many of the cases that had hyaline globules also showed epithelial hyperplasia. Further analysis demonstrated an incidence of rete testis invasion by neoplasm in cases that had hyaline globules, with or without epithelial hyperplasia, that was significantly higher (p less than 0.01) than that seen in neoplastic cases lacking hyaline globules. We concluded that this pseudoneoplastic reaction developed secondary to invasion of the rete testis by tumor. Immunostains supported the nonneoplastic nature of the proliferative lesions and indicated that the globules represented various proteins that had been absorbed from the lumen of the rete testis by the epithelial-lining cells but not successfully secreted.     

A morphological study of the efferent ducts of the human epididymis

Efferent ducts of the human epididymis were studied with a light microscope and a computerized three-dimensional image analyser by preparing complete serial sections. The efferent ducts were characterized by a columnar epithelium, which differed both from the cuboidal epithelium of the rete testis and from the tall columnar epithelium of the epididymal duct. Therefore, the junctions of the efferent ducts with the rete testis and epididymal duct could be identified morphologically. Five or six efferent ducts originated from the dilated extra-testicular rete testis, ran in an extremely tortuous manner and transformed into the epididymal ducts in an end-to-end pattern near the border of the epididymal head and corpus. Computerized image analysis confirmed light microscopical findings and demonstrated three-dimensional structures of the junctions of the efferent ducts with both the rete testis and the epididymal ducts.     

Regulation of Initiation of Meiosis in Fetal Gonads

Undifferentiated 11 day old fetal mouse gonads were cultured for 7 days in media in which tissues of fetal mouse testis or rete testis had grown. The rete testis medium contained a substance, which triggers the male germ cells to enter meiosis. The medium from the testis blocked meiosis in the female germ cells. It is proposed that a meiosis inducing substance. MIS, and a meiosis preventing substance, MPS, are present within the differentiating fetal testis, and that the two substances participate in the control of germ cell behaviour.     

Adenocarcinoma of the rete testis

Summary Adenocarcinoma of the rete testis is a rare tumor. Histologic diagnosis is difficult, and in the past the tumor may have been incorrectly identified in a number of cases, leading to misleading information on the nature and behavior of this neoplasm. We present the case of a 39-year-old man with a long history of a small left hydrocele, who was lost to follow-up and presented again 2 years later with testicular discomfort. Sonographic findings were consistent with a testicular tumor. Histology confirmed low-grade adenocarcinoma of the rete testis, the first reported tumor of this grade. Previously reported cases of rete testis carcinoma are reviewed.     

睾丸网腺癌(1例报告并文献复习)

目的了解睾丸网腺癌的发病和临床特点，提高其早期诊断和治疗水平。方法分析1例睾丸网腺癌患者的临床资料，并结合文献对睾丸网腺癌的临床病理特点、早期诊断和治疗进行讨论。结果术前诊断为左睾丸鞘膜积液、左睾丸肿瘤待排，遂行左高位睾丸切除术，术后病理检查诊断为睾丸网腺癌。免疫组化：AFP（-），PLAP（-），CK（＋），CD30（-），CK20（＋）。术后CT示肝内多发转移瘤、左肾和左肾上腺转移改变。结论睾丸网腺癌是原发于睾丸网纵膈的恶性肿瘤，极为罕见，其临床表现独特，基本治疗是根治性睾丸切除术辅以根治性腹膜后淋巴结清扫术，放疗和化疗效果欠佳。该病预后差，文献报道5年生存率仅为13％。     

Adenocarcinoma of rete testis

Adenocarcinoma of the rete testis is a very rare malignant neoplasm originating in the epithelium of the rete testis. Histologically, it appears as a papillary adenocarcinoma. The first case was reported in the literature in 1853 and since that time only 16 additional cases have been reported. This report represents the eighteenth case.     

Primary adenocarcinoma of the rete testis with preceding diagnosis of pulmonary metastases

We report a case of primary adenocarcinoma of the rete testis in a 55-year-old man with pulmonary metastases that were detected 11 months prior to the diagnosis of the primary lesion. Primary adenocarcinoma of the rete testis is an extremely rare malignant tumor with a poor outcome. The most common primary symptom is a scrotal mass, often accompanied by hydrocele and chronic epididymitis. The diagnosis is often delayed because of non-specific clinical presentation and symptoms. We cannot forget that rete testis is a possible primary site for a primary, unknown metastatic adenocarcinoma.     

The Effect of Epididymal and Testicular Fluids on the Fertilising Capacity of Testicular and Epididymal Spermatozoa

It is possible that the fertilising capacity of spermatozoa in the epididymis is influenced by the epididymal secretion. We have studied this problem by obtaining spermatozoa before entry into the epididymis and after passage through it, incubating both types of spermatozoa in fluids from the rete testis and cauda epididymidis and then checking their fertilising capacity. While spermatozoa from the rete testis were infertile, rete testis fluid did not decrease the fertilising capacity of epididymal sperm from the cauda epididymidis. Fluid from the cauda epididymidis did not promote the fertilising capacity of testicular spermatozoa. These results are discussed in the light of the current understanding of epididymal physiology.