Testis and epididymis
Paratesticular tumors
Serous carcinoma

Author: Swapnil U. Rane, M.D. (see Authors page)

Revised: 8 June 2017, last major update August 2014

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Serous carcinoma [title]
Cite this page: Serous carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/testisserouspapca.html. Accessed June 29th, 2017.
Terminology
Epidemiology
Sites
  • Paratesticular region
  • Commonly involves paratesticular soft tissue in testicular - epididymal groove, visceral tunica vaginalis and rete testis
  • Rarely is confined to testicular parenchyma
Pathophysiology
  • Same as other serous tumors of ovarian type
  • Possible origin from Müllerian metaplasia of mesothelial lining, testicular mesothelial inclusions, embryonic Müllerian remnants
Clinical features
  • Most patients present with a scrotal mass with hydrocele of 4 - 6 weeks duration
  • Less commonly patients present with a hydrocele alone
  • Presentation with metastases is uncommon
Diagnosis
  • Suspected clinico - radiologically and confirmed histologically
  • Clinico - radiological features do not sufficiently distinguish this tumor from other similar tumors in this region, which are more common
Laboratory
  • CA125 may be elevated but is not a consistent feature
Radiology description
  • USG: commonly a 2.0 - 3.5 cm paratesticular mass, associated with a hydrocele
  • If predominantly cystic, may be associated with papillary or solid area at one end
Prognostic factors
  • Has high progression rate and commonly has late metastases
Case reports
Treatment
  • Treatment of choice is high inguinal orchidectomy, followed by chemotherapy
  • Role of inguinal lymph node dissection is not established
Clinical images

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Irregular cystic and solid spaces

Gross description
  • Commonly 1.5 - 3.0 cm
  • Solid, whitish tan, poorly circumscribed, often gritty masses involving soft tissue between testis and epididymis, paratesticular soft tissue or visceral tunica vaginalis
  • Papillary fronds may be visible in grossly cystic tumors
  • Invasive foci are commonly associated with a fibrous reaction
Gross images

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Intratesticular mass

Microscopic (histologic) description
  • Invasive, well formed papillae lined by serous cuboidal or columnar cells with eosinophilic cytoplasm and marked atypia
  • Abundant psammoma bodies
  • Areas of borderline serous tumor often present and rarely can be the dominant component
  • Most tumors have nuclear grade II or III
Microscopic (histologic) images

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Papillary tumor cluster

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WT1+

Positive stains
Electron microscopy description
  • Gland formation with delicate luminal microvilli and cilia
Differential diagnosis