Male adnexal tumour of probable Wolffian origin occurring in a seminal vesicle.

AIMS: Adnexal tumours of probable Wolffian origin are rare low-grade malignant neoplasms that have been previously described in the broad ligament, ovaries and retroperitoneum of females. All are characterized by small, bland epithelial cells growing in a diffuse, trabecular, or tubular pattern. The majority of the cases reported have pursued a benign clinical course. However, recurrences and distant metastases have been described. We present a case of a male adnexal tumour of probable Wolffian origin occurring in the left seminal vesicle of a 29-year-old man with 23 years of follow-up. RESULTS: The diagnosis is supported by immunohistochemical and electron microscopic findings: The tumour cells were immunoreactive for cytokeratin and vimentin while smooth muscle antigen and S100 protein were uniformly negative. By electron microscopy cells were arranged in an acinar pattern and surrounded flocculent, electron-dense material. Individual cells contained numerous dense bodies and free ribrosomes. The patient had recurrences at 14 and 23 years after initial diagnosis. CONCLUSION: This is the first report of this entity in a male. The literature on this unusual tumour is reviewed and the clinicopathological, immunohistochemical and ultrastructural features are described. The differential diagnosis of this seemingly indolent tumour is discussed with genitourinary tumours having a more aggressive clinical course.

Lung carcinoma with metastasis to testicular seminoma.

Tumor-to-tumor metastases are uncommon. The most frequent donor tumors are the lung, whereas renal cell carcinoma is by far the most common recipient. In this report the authors describe a lung tumor that metastasized to a testicular seminoma. This is the first reported case of tumor-to-tumor metastases in which seminoma of the testis is the recipient. The authors performed mucin and immunohistochemical studies on this case and on ten cases of nonseminomatous germ cell tumors containing embryonal carcinoma and endodermal sinus tumor for comparison. Mucin positivity as well as immunoreactivity for epithelial membrane and carcinoembryonic antigens were confined to metastatic adenocarcinoma in this case, whereas Ki-1 and alpha-fetoprotein immunostaining were restricted to the ten control cases of germ cell tumors. Although the majority of second malignant components found in a seminoma are other nonseminomatous germ cell components, the rare possibility exists that a second malignant component is a metastasis from elsewhere in the body.

Renal-cell carcinoma with intranuclear inclusions metastatic to thyroid: a diagnostic problem in aspiration cytology.

A case of renal-cell carcinoma (RCC) exhibiting prominent intranuclear inclusions in a metastasis to the thyroid is presented. RCC had been treated in this patient by right nephrectomy 7 yr earlier and by left partial nephrectomy 5 yr earlier; the patient had also received radiation to the neck 4 yr earlier for carcinoma in situ of the left true vocal cord. Aspiration performed on a rapidly enlarging mass in the left lobe of the thyroid revealed both clusters of tumor cells and single tumor cells with prominent intranuclear inclusions. Definitive distinction between a primary and metastatic neoplasm was difficult on the aspiration specimen. Subsequent thyroidectomy confirmed the diagnosis of metastatic renal-cell carcinoma with intranuclear inclusions by histologic, immunohistochemical, and ultrastructural analysis. The differential diagnosis by aspiration cytology of thyroid neoplasms that contain intranuclear inclusions is discussed.

Fine needle aspiration cytology of myositis ossificans.

Fine needle aspiration was performed on a large soft tissue mass of the left thigh and hip region in a 27-year-old paraplegic man. Cytologic examination revealed sheets of immature fibroblasts and scattered skeletal muscle cells in various stages of degeneration compatible with myositis ossificans. This case is probably the first needle aspiration cytology of this lesion. The danger of confusing the cytology with that of a sarcoma is emphasized.