Case of the Month
A 53-year-old man presented with scrotal pain and a 1.5 cm testicular mass. Special stain for mucicarmine was negative. Immunohistochemistry (IHC) was negative for pancytokeratin, CK7, CK20, CDX2, inhibin, OCT-3/4, and chromogranin. What is the most likely diagnosis?
What is your diagnosis?
a. Leydig cell tumor
b. Sertoli cell tumor
c. Metastatic signet ring carcinoma from the colon
d. Primary signet ring stromal tumor of the testis
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We will reveal the answer next month.
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Answer to May’s Case of the Month...
C. Mucoepidermoid carcinoma
This is a Warthin-like variant of mucoepidermoid carcinoma. At low power, the cystic nature of the process and the prominent lymphoid stroma are similar to Warthin’s tumor, but the classic bilayered oncocytic epithelium of that lesion is absent. There is no sebaceous type epithelium present, and the irregular, haphazard nature of the cystic spaces is somewhat unusual for sebaceous adenoma or lymphoepithelial cyst. In difficult cases, diagnosticians can pursue testing for the MAML2 translocation, which is present in mucoepidermoid carcinoma and absent in the other entities.
Submitted by Frank Ingram and Patrick Ware, Presbyterian Pathology Group, North Carolina, USA.
