Testis & paratestis
Ovarian type tumors
Serous borderline tumor
Author: Swapnil U. Rane, M.D.
Last author update: 1 August 2014
Last staff update: 20 October 2022
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Serous borderline tumor
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology and Pathophysiology | Clinical features | Diagnosis | Laboratory | Radiology description | Prognostic factors | Case reports | Treatment | Gross description | Microscopic (histologic) description | Cytology description | Positive stains | Negative stains | Molecular / cytogenetics description | Differential diagnosisCite this page: Rane S. Serous borderline tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisserousborder.html. Accessed April 24th, 2024.
Definition / general
- Serous epithelial tumor of low malignant potential occurring in paratesticular region
Terminology
- Same as ovarian counterparts
Epidemiology
- Rare tumor but more common than malignant serous epithelial tumors
- Mean patient age in the largest reported series was 56 years, range of 14 - 77 years (Am J Surg Pathol 2001;25:373)
Sites
- Tunica is most common site, commonly arising from tunica albuginea
- Tunica vaginalis, spermatic cord are other common sites
- Tumor may extend to testis
Etiology and Pathophysiology
- Postulated cell of origin is Müllerian metaplasia of mesothelial lining
- Cases arising in testis are explained by Müllerian metaplasia occurring in mesothelial cell inclusions within testicular parenchyma
- Embryological Müllerian remnants within testis and paratestis are also postulated to give rise to these tumors
Clinical features
- Painless testicular mass in elderly male is most common presentation
Diagnosis
- Suspected clinico - radiologically and confirmed histologically
Laboratory
- No specific laboratory abnormality
Radiology description
- Cystic lesion arising in paratesticular / testicular region
- Broad papillae may be visualized but there are no specific diagnostic criteria
Prognostic factors
- No reports of recurrence of serous borderline tumors but lesion is rare and reported follow up is only 2 years
Case reports
- 59 year old men (Hum Pathol 1992;23:75, Anticancer Res 2012;32:5011)
- 64 year old man with serous borderline tumor of the paratestis (Pathol Int 2008;58:311)
Treatment
- Radical orchidectomy is treatment of choice
- No cases reported have recurred with or without chemotherapy but need for adjuvant chemotherapy needs to be assessed for each case
Gross description
- 1 - 6 cm grossly cystic lesion arising within paratestis / testis
- Cyst wall is variably thickened with protrusions
- Papillae may be visualized focally but usually are not a prominent feature
Microscopic (histologic) description
- Histologically identical to their ovarian counterpart
- Tumors are cystic with numerous intracystic blunt papillae lined by ciliated stratified columnar cells with minimal to mild cytologic atypia
- Psammoma bodies may be present
- Cyst wall shows variable amount of fibrous tissue
- Ki67 staining index varies from 1% to 10%
Cytology description
- Fluid smears with scattered epithelial cells
- Occasional papillary frond may be visualized but is usually not a prominent feature
Negative stains
- CK20, CEA, HER2, calretinin
Molecular / cytogenetics description
- No specific cytogenetic abnormality has been documented
Differential diagnosis
- Adenomatoid tumor
- Malignant mesothelioma
- Metastatic adenocarcinoma
- Serous cystadenocarcinoma
