Difference between revisions of "Testicular scar"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Testicular_scar_--_low_mag.jpg
| Width      =
| Caption    = Testicular scar. [[H&E stain]].
| Synonyms  = scar of testis
| Micro      = seminiferous tubules replaced by fibrosis (hyaline material with a relatively low cellularity and no nuclear atypia) +/-hemosiderin-laden macrophages, atrophic changes (see ''[[testicular atrophy]]'')
| Subtypes  =
| LMDDx      = necrotic tumour, (residual) testicular tumour (e.g. [[germ cell tumour]])
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = tan brown or white, well-circumscribed
| Grossing  =
| Site      = [[testis]]
| Assdx      =
| Syndromes  =
| Clinicalhx = +/-history of testicular tumour
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  = unremarkable
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = (residual) testicular tumour
| Tx        =
}}
'''Testicular scar''', also '''scar of testis''', is a phenomenon that may arise in the context of treatment for a [[germ cell tumour]]<ref>{{cite journal |author=Ramsey S, Kerr G, Howard GC, Donat R |title=Orchidectomy after primary chemotherapy for metastatic testicular cancer |journal=Urol. Int. |volume=91 |issue=4 |pages=439–44 |year=2013 |pmid=24021555 |doi=10.1159/000350858 |url=}}</ref> or result from the spontaneous regression of a (germ cell) tumour.<ref name=pmid16819328>{{cite journal |author=Balzer BL, Ulbright TM |title=Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases |journal=Am. J. Surg. Pathol. |volume=30 |issue=7 |pages=858–65 |year=2006 |month=July |pmid=16819328 |doi=10.1097/01.pas.0000209831.24230.56 |url=}}</ref>
'''Testicular scar''', also '''scar of testis''', is a phenomenon that may arise in the context of treatment for a [[germ cell tumour]]<ref>{{cite journal |author=Ramsey S, Kerr G, Howard GC, Donat R |title=Orchidectomy after primary chemotherapy for metastatic testicular cancer |journal=Urol. Int. |volume=91 |issue=4 |pages=439–44 |year=2013 |pmid=24021555 |doi=10.1159/000350858 |url=}}</ref> or result from the spontaneous regression of a (germ cell) tumour.<ref name=pmid16819328>{{cite journal |author=Balzer BL, Ulbright TM |title=Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases |journal=Am. J. Surg. Pathol. |volume=30 |issue=7 |pages=858–65 |year=2006 |month=July |pmid=16819328 |doi=10.1097/01.pas.0000209831.24230.56 |url=}}</ref>


==General==
==General==
*Well-reported uncommon finding.
*Well-reported uncommon finding.
*May result from the spontaneous regression of a (germ cell) tumour.<ref name=pmid16819328>{{cite journal |author=Balzer BL, Ulbright TM |title=Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases |journal=Am. J. Surg. Pathol. |volume=30 |issue=7 |pages=858–65 |year=2006 |month=July |pmid=16819328 |doi=10.1097/01.pas.0000209831.24230.56 |url=}}</ref>
*Can be the result of trauma, (a prior untreated) [[testicular torsion]] or infection.
==Gross==
*Tan-brown or white lesion.
*Well-circumscribed.


==Microscopic==
==Microscopic==
Features:
Features:
*Seminiferous tubules replaced by fibrosis.
*Seminiferous tubules replaced by fibrosis.
**Hyaline material with a relatively low cellularity and no nuclear atypia.
*+/-Hemosiderin-laden macrophages.
*+/-Hemosiderin-laden macrophages.
*Atrophic changes<ref name=pmid16819328/> - see ''[[testicular atrophy]]''.
*Atrophic changes<ref name=pmid16819328/> - see ''[[testicular atrophy]]''.


DDx:
DDx:
*Necrotic tumour.
*[[necrosis|Necrotic]] tumour.
*[[Germ cell tumour]], e.g. [[seminoma]].
*[[Germ cell tumour]], e.g. [[seminoma]].
*Regressed germ cell tumour - suggestive features:<ref name=pmid16819328/>
**Distinct scar +/-[[germ cell neoplasia in situ]] (GCNIS) +/-coarse calcifications (intratubular).
**Scar with prominent (small) blood vessels (weakly suggestive).
**Scar with lymphoplasmacytic inflammatory infiltrate (weakly suggestive).
===Images===
<gallery>
Image: Testicular scar -- very low mag.jpg | Testicular scar - very low mag.
Image: Testicular scar -- low mag.jpg | Testicular scar - low mag.
Image: Testicular scar -- intermed mag.jpg | Testicular scar - intermed. mag.
Image: Testicular scar -- high mag.jpg | Testicular scar - high mag.
Image: Testicular scar - alt -- high mag.jpg | Testicular scar - high mag.
Image: Testicular scar -- very high mag.jpg | Testicular scar - very high mag.
</gallery>


==Sign out==
==Sign out==
<pre>
<pre>
TESTICLE, LEFT, ORCHIECTOMY:
TESTICLE, RIGHT, ORCHIECTOMY:
- TESTICULAR SCAR REPLACING MOST OF THE SEMINIFEROUS TUBULES.
- TESTICULAR SCAR REPLACING MANY OF THE SEMINIFEROUS TUBULES.
- REMAIN SEMINIFEROUS TUBULES WITH ATROPHIC CHANGES.
- REMAINING SEMINIFEROUS TUBULES WITH ATROPHIC CHANGES.
- BENIGN SPERMATIC CORD AND EPIDIDYMIS.
- NO EVIDENCE OF RESIDUAL GERM CELL TUMOUR.
- NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR MALIGNANCY.
</pre>
</pre>

Latest revision as of 23:37, 15 March 2016

Testicular scar
Diagnosis in short

Testicular scar. H&E stain.
Synonyms scar of testis
LM seminiferous tubules replaced by fibrosis (hyaline material with a relatively low cellularity and no nuclear atypia) +/-hemosiderin-laden macrophages, atrophic changes (see testicular atrophy)
LM DDx necrotic tumour, (residual) testicular tumour (e.g. germ cell tumour)
Gross tan brown or white, well-circumscribed
Site testis
Clinical history +/-history of testicular tumour
Prevalence uncommon
Blood work unremarkable
Prognosis benign
Clin. DDx (residual) testicular tumour

Testicular scar, also scar of testis, is a phenomenon that may arise in the context of treatment for a germ cell tumour[1] or result from the spontaneous regression of a (germ cell) tumour.[2]

General

  • Well-reported uncommon finding.
  • May result from the spontaneous regression of a (germ cell) tumour.[2]
  • Can be the result of trauma, (a prior untreated) testicular torsion or infection.

Gross

  • Tan-brown or white lesion.
  • Well-circumscribed.

Microscopic

Features:

  • Seminiferous tubules replaced by fibrosis.
    • Hyaline material with a relatively low cellularity and no nuclear atypia.
  • +/-Hemosiderin-laden macrophages.
  • Atrophic changes[2] - see testicular atrophy.

DDx:

  • Necrotic tumour.
  • Germ cell tumour, e.g. seminoma.
  • Regressed germ cell tumour - suggestive features:[2]
    • Distinct scar +/-germ cell neoplasia in situ (GCNIS) +/-coarse calcifications (intratubular).
    • Scar with prominent (small) blood vessels (weakly suggestive).
    • Scar with lymphoplasmacytic inflammatory infiltrate (weakly suggestive).

Images

  • Testicular scar - very low mag.

  • Testicular scar - low mag.

  • Testicular scar - intermed. mag.

  • Testicular scar - high mag.

  • Testicular scar - high mag.

  • Testicular scar - very high mag.

Sign out

TESTICLE, RIGHT, ORCHIECTOMY:
- TESTICULAR SCAR REPLACING MANY OF THE SEMINIFEROUS TUBULES.
- REMAINING SEMINIFEROUS TUBULES WITH ATROPHIC CHANGES.
- BENIGN SPERMATIC CORD AND EPIDIDYMIS.
- NO EVIDENCE OF RESIDUAL GERM CELL TUMOUR.
- NEGATIVE FOR MALIGNANCY.

See also

References

  1. ↑ Ramsey S, Kerr G, Howard GC, Donat R (2013). "Orchidectomy after primary chemotherapy for metastatic testicular cancer". Urol. Int. 91 (4): 439–44. doi:10.1159/000350858. PMID 24021555.
  2. ↑ 2.0 2.1 2.2 2.3 Balzer BL, Ulbright TM (July 2006). "Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases". Am. J. Surg. Pathol. 30 (7): 858–65. doi:10.1097/01.pas.0000209831.24230.56. PMID 16819328.
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