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The Korean Journal of Pathology 2008;42(4): 229-231.
A Diagnostically Challenging Case of an Infarcted Adenomatoid Tumor of the Epididymis.
Sunhee Chang, Sang Hwa Shim, Ji Eun Kwak, Mee Joo, Hanseong Kim, Je G Chi, Keon cheol Lee
1Department of Pathology, InJe University Ilsan Paik Hospital, Goyang, Korea. changsh@ilsanpaik.ac.kr
2Department of Urology, InJe University Ilsan Paik Hospital, Goyang, Korea.
ABSTRACT
We describe a case of an infarcted adenomatoid tumor of the epididymis that was challenging to diagnose. A 20-year-old man presented with acute left scrotal pain. He was found to have a 2x1.5x1 cm tumor that was relatively well circumscribed on gross examination. There was a central necrotic area that exhibited gaping spaces and ghost outlines of epithelial cells. The periphery of the necrotic lesion showed focally viable adenomatoid tumor. The majority of the tissue adjacent to the necrosis consisted of granulation tissue, fibroblastic and myofibroblastic proliferation, and neutrophils. The fibroblasts and myofibroblasts showed plump nuclei, often with small nucleoli. No mitotic activity was present. The differential diagnosis for an infarcted adenomatoid tumor includes malignant mesothelioma, inflammatory myofibroblastic tumor, and inflammatory conditions. The key to diagnosing an infarcted adenomatoid tumor is to consider it in the differential diagnosis of any spindle cell tumor with necrosis occurring in the genital tract.
Key Words: Adenomatoid tumor; Infarction; Epididymis
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