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Frustration with awaiting pathology results

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  • #31
    Here is a pretty good summary of fibrothecomas I found in a urology textbook available on Google Books to browse. The entry says that it's a stromal tumor, so if you would be willing to consent to research and release your patient records the International Ovarian and Testicular Stromal Tumor Registry (https://www.otstregistry.org/) might he helped with information regarding your tumor. They also will likely do their own additional pathology review on your slides. I've submitted my case, and it might help future understanding of these tumors, so please consider contacting them.

    Genitourinary Pathology: Practical Advances, Edited by Cristina Magi-Galluzzi, Christopher G. Przybycin, Page 458

    Fibrothecoma

    Thecomas are benign stromal tumors arising from ovarian theca cells and constitute 1% of all ovarian tumors. Ovarian stromal tumors are classified into either thecoma or fibroma, and frequently grouped together as “fibrothecoma.”

    Testicular fibrothecoma is a rare intratesticular spindle cell neoplasm [33]. It presents most commonly in the third and fourth decades of life as a painless ​testicular mass, or rarely with scrotal pain. It ranges from 0.5 to 7.6cm in diameter and appears as a tan-white, well-circumscribed, although not encapsulated, firm nodule [34]. Macroscopically, fibrothecomas typically about the tunica albuginea; occasionally they may be centered on the retentions testis. Hemorrhage or necrosis is not present. Microscopically, the tumor is mildly to markedly cellular with bland spindle cells arranged in a randomly interweaving or storiform pattern (Fig. 35.23). Small dilated blood vessels are frequently present. Various degrees of collagen deposition can be seen, either in bands or investing individual cells, and may form acellular plaques within the tumor. Tumor cells show variable immunoreactivity for inhibin, calretinin, melan-A, pan keratin, smooth muscle actin, and vimentin [33, 34]. Although testicular fibrothecoma may show worrisome features including minimal invasion in the the surrounding storm, elevated mitotic rates, and high cellularity, their behavior appears to be uniformly benign [34].

    Thecoma is an extremely rare tumor in the testis and only two cases have been reported to date, one of them in the content of the Gorlin syndrome. This tumor arose from the tunica albuginea of the testis and was composed predominantly by spindle cells with occasional luteinization [35].
    Last edited by sayhey; 10-12-18, 02:36 PM. Reason: Formatting change

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