Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2
Testicular neuroendocrine tumors (NET) or carcinoid tumors are rare neoplasms which represent 1% of all testicular tumors and can be divided into 3 subgroups: pure primary testicular NET, primary testicular NET associated with a teratoma, and NET metastases to the testis. We report an unusual presen...
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| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Pathology |
| Online Access: | http://dx.doi.org/10.1155/2013/709352 |
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| author | Jonathan R. Epperson Necia M. Pope Margaret J. Abuzeid |
| author_facet | Jonathan R. Epperson Necia M. Pope Margaret J. Abuzeid |
| author_sort | Jonathan R. Epperson |
| collection | DOAJ |
| description | Testicular neuroendocrine tumors (NET) or carcinoid tumors are rare neoplasms which represent 1% of all testicular tumors and can be divided into 3 subgroups: pure primary testicular NET, primary testicular NET associated with a teratoma, and NET metastases to the testis. We report an unusual presentation of a primary testicular neuroendocrine tumor in a 39-year-old male who presented after a physical altercation during a soccer game. Histology showed a diffuse infiltrating tumor with extensive involvement of the tunica albuginea and tunica vaginalis. Immunohistochemical expression of CD56, synaptophysin, and chromogranin A was strongly positive in the tumor cells. Foci of tumor cell necrosis and occasional mitotic figures as well as extensive lymph-vascular invasion were also identified. A review of the literature reveals differing opinions on the prognostic significance of primary tumor size, mitotic index, tumor necrosis, and nuclear atypia. In our patient, the increased mitotic rate (3–5 mitotic figures per 10 hpf and a Ki-67 index of 5%), foci of necrosis, and mild to moderate nuclear atypia warranted a diagnosis of neuroendocrine tumor grade 2, formerly atypical carcinoid. Long term surveillance in these patients is essential as metastasis occurs in up to 15% of cases. At the 6-month followup, the patient remains symptom free. |
| format | Article |
| id | doaj-art-eb0d8e73f2954fac8aae28c74b0cd50c |
| institution | DOAJ |
| issn | 2090-6781 2090-679X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pathology |
| spelling | doaj-art-eb0d8e73f2954fac8aae28c74b0cd50c2025-08-20T03:21:23ZengWileyCase Reports in Pathology2090-67812090-679X2013-01-01201310.1155/2013/709352709352Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2Jonathan R. Epperson0Necia M. Pope1Margaret J. Abuzeid2Department of Pathology and Laboratory Services, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, San Antonio, TX 78234, USADepartment of Urology, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, San Antonio, TX 78234, USADepartment of Pathology and Laboratory Services, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, San Antonio, TX 78234, USATesticular neuroendocrine tumors (NET) or carcinoid tumors are rare neoplasms which represent 1% of all testicular tumors and can be divided into 3 subgroups: pure primary testicular NET, primary testicular NET associated with a teratoma, and NET metastases to the testis. We report an unusual presentation of a primary testicular neuroendocrine tumor in a 39-year-old male who presented after a physical altercation during a soccer game. Histology showed a diffuse infiltrating tumor with extensive involvement of the tunica albuginea and tunica vaginalis. Immunohistochemical expression of CD56, synaptophysin, and chromogranin A was strongly positive in the tumor cells. Foci of tumor cell necrosis and occasional mitotic figures as well as extensive lymph-vascular invasion were also identified. A review of the literature reveals differing opinions on the prognostic significance of primary tumor size, mitotic index, tumor necrosis, and nuclear atypia. In our patient, the increased mitotic rate (3–5 mitotic figures per 10 hpf and a Ki-67 index of 5%), foci of necrosis, and mild to moderate nuclear atypia warranted a diagnosis of neuroendocrine tumor grade 2, formerly atypical carcinoid. Long term surveillance in these patients is essential as metastasis occurs in up to 15% of cases. At the 6-month followup, the patient remains symptom free.http://dx.doi.org/10.1155/2013/709352 |
| spellingShingle | Jonathan R. Epperson Necia M. Pope Margaret J. Abuzeid Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2 Case Reports in Pathology |
| title | Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2 |
| title_full | Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2 |
| title_fullStr | Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2 |
| title_full_unstemmed | Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2 |
| title_short | Rare Testicular Tumor Discovered by Assault: An Unusual Presentation of a Primary Testicular Neuroendocrine Tumor Grade 2 |
| title_sort | rare testicular tumor discovered by assault an unusual presentation of a primary testicular neuroendocrine tumor grade 2 |
| url | http://dx.doi.org/10.1155/2013/709352 |
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