Case of the Week

2020-6 / FEBRUARY 10 (CONTRIBUTOR: JONATHAN EPSTEIN)

A 58 year old man presented with a cystic 8.0 cm. mass in the testis.

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Quiz

1. What is the correct diagnosis?

a. Choriocarcinoma

b. Metastatic squamous cell carcinoma

c. Epithelioid trophoblastic tumor

d. Somatic malignancy arising in a teratoma

The tumor consisted a mixture of squamoid cells with abundant pink “hard” cytoplasm and mostly single, pleomorphic, and hyperchromatic nuclei with variably prominent nucleoli. Occasional multinucleated cells were also present. The cytoplasmic membranes were well defined and prominent without discernible intercellular bridges. The tumor lacked the dimorphic population of syncytiotrophoblasts and cytotrophoblasts along with hemorrhagic necrosis typical of choriocarcinoma. The cyst was lined by extracellular fibrinoid material. The lesion stained diffusely positive for p63, positive for HCG, and focally for GATA3. This immunoprofile and morphology is classic for epithelioid trophoblastic tumor (ETT). In contrast to choriocarcinoma, ETT in the testis when totally excised should have an excellent prognosis. However, close follow up is warranted due to the rarity of these lesions in the testis with limited reported follow-up.

About GUPS

The Genitourinary Pathology Society (GUPS) was formed with the vision of advancing the care of patients with urologic diseases through enhancements of best practices, research, and education in the subspecialty of Urological Pathology.

GUPS is an official Companion Society of the United States and Canadian Academy of Pathology (USCAP).

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