Testis and epididymis
Paratesticular tumors
Male adnexal tumor of probable Wolffian origin

Topic Completed: 1 May 2014

Revised: 28 March 2019

Copyright: 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: Male adnexal tumor probable Wolffian

Swapnil U. Rane, M.D.
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Cite this page: Rane S. Male adnexal tumor of probable Wolffian origin. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisparatest.html. Accessed February 21st, 2020.
Definition / general
  • Also called Wolffian hamartoma
  • Sometimes grouped under the broad term of "benign epithelial proliferations"
  • Extremely rare in men, more common in women
  • Usually presents as a tumor in 4th to 5th decade
  • Paratesticular location, commonly around the rete testis, epididymis, vas deferens and seminiferous tubules
Pathophysiology and Etiology
  • Tumors are believed to arise from Wolffian duct remnants, although precise etiology is unknown
  • Though the incidence of Wolffian duct remnants is much higher, they are commonly incidental findings on autopsies or surgical specimens
Clinical features
  • Symptoms include pain, difficulty initiating micturition and sexual dysfunction
  • Most tumors are benign
  • Single case of metastases reported (Scand J Urol Nephrol 2009;43:253), although as reported, malignant mesothelioma cannot be excluded
  • Biopsy / surgical excision required for definitive diagnosis
Case reports
  • Surgical excision
Gross description
  • 4 - 8 cm, multicystic
  • Distinct from epididymis and vas deferens
Microscopic (histologic) description
  • Unilocular or multicystic mass lined by a single layer of cuboidal to tall columnar epithelium with apical cilia
  • Secretions are commonly seen on apical aspect of cells and in lumen
  • Nuclei are usually bland with little pleomorphism or mitosis
  • Cysts are surrounded by variable connective tissue / fibromuscular stroma
  • Lymphovascular emboli or invasive features are usually absent
Microscopic (histologic) images

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Female Wolffian adnexal tumor

Positive stains
Negative stains
Electron microscopy description
  • Short villi are prominent unlike the long bushy villi of mesothelioma
  • Intraluminal flocullent densities representing secretions and free ribosomes are prominent
  • Mitochondria are sparse
Differential diagnosis
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