Case of the Month
A 77-year-old man presented with an arcuate, erythematous patch on his lower back. The lesion was painful and pruritic. A biopsy was performed; histology from the case is presented above.
What is the most likely diagnosis?
a. Wells’ syndrome
b. Ofuji disease
c. Angiolymphoid hyperplasia with eosinophilia
e. Allergic contact dermatitis
We will reveal the answer next month.
Do you have an interesting case that you would like us to feature? Email it to [email protected].
Answer to June’s Case of the Month...
D. Primary signet ring stromal tumor of the testis
Primary signet ring stromal tumor of the testis (PSRSTT) is a rare benign testicular tumor originally described in 2005 (1). The tumor is typically composed of low-grade epithelioid cells, most of which contain a large cytoplasmic vacuole. These vacuoles compress and displace peripherally the nucleus of each tumor cell, imparting a signet ring-like appearance. PSRSTT must be distinguished from metastatic signet ring carcinoma of the gastrointestinal tract; in this case, negative IHC data were useful for the final diagnosis. Data from the literature indicate that the tumors are positive for β-catenin, cyclin D1, CD10, galectin-3, claudin 7, and neuron-specific enolase (2).
The histogenesis of these rare tumors is unknown. Recent immunohistochemical and molecular biology data suggest that this tumor is a testicular analogue of pancreatic solid pseudopapillary tumor (2).
- M Michal et al., “Primary signet-ring stromal tumor of the testis”, Virchows Arch, 447, 107 (2005). PMID: 15909171.
- K Michalova et al., “Primary signet ring stromal tumor of the testis: a study of 13 cases indicating their phenotypic and genotypic analogy to pancreatic solid pseudopapillary neoplasm”, Hum Pathol, 67, 85 (2017). PMID: 28739499.
Submitted by Živka Eri, Professor of Pathology, Medical Faculty, University of Novi Sad, Serbia.
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