J Pathol Transl Med.  2021 Nov;55(6):410-414. 10.4132/jptm.2021.09.11.

Primary testicular carcinoid tumor with marked lymphovascular invasion

• Lee HJ
• Park JY
• Kim SY
• Hwang CS
• Lee JH
• Shin DH
• Kim JY

• KMID: 2522443
• DOI: http://doi.org/10.4132/jptm.2021.09.11

Abstract

Testicular carcinoid tumors are very rare, accounting for less than 1% of all testicular tumors. We report a rare case of a testicular carcinoid tumor with extensive lymphatic invasion. A 42-year-old man presented with a painless, enlarged right testicular mass. There was no history of injury or discomfort in this region. Right radical orchiectomy was performed, which showed a well-defined, non-encapsulated solid white mass with calcification (7.0 × 4.5 × 3.5 cm) and absence of cystic components. Microscopic examination using hematoxylin and eosin staining of the tumor sections identified organoid, trabecular, and solid patterns with rosette formation. Extensive multifocal lymphatic invasion was observed. Immunohistochemistry was positive for synaptophysin, chromogranin, and CD56. Testicular carcinoid tumors usually show good prognoses; however, there was extensive lymphovascular invasion in this case. Thus, in the case of unusual presentation of the disease, close follow-up is necessary.

Keyword

Testicular carcinoid tumor; Testicular neoplasm; Lymphovascular invasion; Orchiectomy

Figure

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  Fig. 1 Gross appearance of the right testicular mass. (A) A well-defined, non-encapsulated solid white mass is observed. (B) The cut surface is clear and evenly white without hemorrhage or necrosis.

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  Fig. 2 Microscopic findings of the testicular carcinoid tumor. (A) Organoid, trabecular, and solid patterns are visible. (B) The cells have a uniform polygonal appearance with fine granular cytoplasm and round nuclei containing fine chromatin and small nucleoli. (C, D) Extensive multifocal lymphatic invasion is detected.

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  Fig. 3 Immunohistochemical staining is positive for chromogranin and (A) synaptophysin (B). (C) CD31 shows positivity for lymphovascular endothelium. (D) D2-40 shows positivity for lymphatic endothelium.

Reference

References

1. Ulbright TM, Young RH. Carcinoid tumor of the testis. Am J Clin Pathol. 2004; 121:297.

2. Simon HB, Mc DJ, Culp OS. Argentaffin tumor (carcinoid) occurring in a benign cystic teratoma of the testicle. J Urol. 1954; 72:892–4.

3. Singer AJ, Anders KH. Primary carcinoid of the testis 25 years after contralateral testicular seminoma. Urology. 2001; 57:554–5.

4. Zavala-Pompa A, Ro JY, el-Naggar A, et al. Primary carcinoid tumor of testis. Immunohistochemical, ultrastructural, and DNA flow cytometric study of three cases with a review of the literature. Cancer. 1993; 72:1726–32.

5. Stroosma OB, Delaere KP. Carcinoid tumours of the testis. BJU Int. 2008; 101:1101–5.

6. Lu C, Zhang Z, Jiang Y, et al. Primary pure carcinoid tumors of the testis: Clinicopathological and immunophenotypical characteristics of 11 cases. Oncol Lett. 2015; 9:2017–22.

7. Soga J. Carcinoids and their variant endocrinomas: an analysis of 11842 reported cases. J Exp Clin Cancer Res. 2003; 22:517–30.

8. Sun GH, Fang DB, Shen ZJ, Cai SL. Diagnosis of the testicular tumor (57 case reports). Zhonghua Nan Ke Xue. 2003; 9:364–6.

9. Kato N, Motoyama T, Kameda N, et al. Primary carcinoid tumor of the testis: immunohistochemical, ultrastructural and FISH analysis with review of the literature. Pathol Int. 2003; 53:680–5.

10. Reyes A, Moran CA, Suster S, Michal M, Dominguez H. Neuroendocrine carcinomas (carcinoid tumor) of the testis: a clinicopathologic and immunohistochemical study of ten cases. Am J Clin Pathol. 2003; 120:182–7.

11. Frank RG, Gerard PS, Anselmo MT, Bennett L, Preminger BI, Wise GJ. Primary carcinoid tumor of the testis. Urol Radiol. 1991; 12:203–5.

12. Talerman A, Gratama S, Miranda S, Okagaki T. Primary carcinoid tumor of the testis: case report, ultrastructure and review of the literature. Cancer. 1978; 42:2696–706.

13. Roth LM, Talerman A. Recent advances in the pathology and classification of ovarian germ cell tumors. Int J Gynecol Pathol. 2006; 25:305–20.

14. Wang WP, Guo C, Berney DM, et al. Primary carcinoid tumors of the testis: a clinicopathologic study of 29 cases. Am J Surg Pathol. 2010; 34:519–24.