Uschuplich Vedran, Hilsenbeck John R, Velasco Claude R
Department of Pathology, University of Tennessee Medical Center, 1924 Alcoa Hwy, Box 108, Knoxville, TN 37920, USA.
Arch Pathol Lab Med. 2006 Nov;130(11):1715-7. doi: 10.5858/2006-130-1715-PMCAFA.
A mucinous cystadenoma of the paratestis arising from an unequivocal oviduct-like structure in an 18-year-old man is reported. Mucinous cystadenomas of the testis and paratestis are extremely rare benign tumors of controversial origin. The diagnosis may be challenging and is of clinical importance because these lesions may mimic a teratoma, and teratomas in postpubertal males carry a malignant potential regardless of the degree of maturation. A few case reports and reviews of testicular and paratesticular mucinous neoplasms resembling ovarian tumors have suggested the possibility of a müllerian origin of these tumors. However, no histologic evidence has been found to support such a histogenesis. The current case demonstrates a clear transition from müllerian-type tubal epithelium to intestinal-type mucinous epithelium. This finding, in conjunction with immunophenotypic studies, strongly supports a derivation from a paratesticular müllerian remnant. To our knowledge this represents the first substantial evidence that, in at least some cases, mucinous cystadenomas of the testis and paratestis are of müllerian derivation.
本文报告了一名18岁男性，其睾丸旁出现了起源于明确输卵管样结构的黏液性囊腺瘤。睾丸和睾丸旁的黏液性囊腺瘤是极为罕见的良性肿瘤，其起源存在争议。诊断可能具有挑战性且具有临床重要性，因为这些病变可能酷似畸胎瘤，而青春期后男性的畸胎瘤无论成熟程度如何都有恶变潜能。一些关于睾丸和睾丸旁黏液性肿瘤（类似卵巢肿瘤）的病例报告及综述提示这些肿瘤可能起源于苗勒管。然而，尚未发现支持这种组织发生学的组织学证据。当前病例显示从苗勒管型输卵管上皮向肠型黏液上皮有明显转变。这一发现与免疫表型研究相结合，有力地支持了其起源于睾丸旁苗勒管残余组织的观点。据我们所知，这是首个有力证据，表明至少在某些情况下，睾丸和睾丸旁的黏液性囊腺瘤起源于苗勒管。
