title: Primary carcinoid tumor of testis. Immunohistochemical, ultrastructural, and DNA flow cytometric study of three cases with a review of the literature.
abstract: The cases of three patients with primary carcinoid tumor of the testis were reported. The patients were 41, 44, and 83 years of age. At initial examination, all three had testicular masses with or without associated pain, and none had the carcinoid syndrome. The tumors measured 4.3 cm, 3.0 cm, and 6.5 cm in dimension. All three tumors manifested classic histologic features of carcinoid tumors. The neoplastic cells exhibited argyrophilia, and all were immunoreactive to chromogranin, serotonin, neuron-specific enolase, and cytokeratin. Two tumors had positive test results for gastrin and one had positive test results for substance P and vasoactive intestinal polypeptide. No tumors reacted with somatostatin, insulin, pancreatic polypeptide, or placental alkaline phosphatase. Intracytoplasmic, membrane-bound, round-to-elliptical pleomorphic granules were identified by ultrastructural analysis in all cases. DNA flow cytometric analysis revealed a low degree (near-diploid) DNA aneuploidy in all cases, with a DNA index of 1.15 in two tumors and 1.3 in the third tumor. The three patients are alive and well 11 years, 7 years, and 6 months, respectively, after diagnosis. A total of 57 cases of this entity, including the 3 reported here, have been reported. Of these, 43 were pure carcinoid, and 14 were associated with teratoma; 6 (11.6%) patients developed metastases. Tumor size and the presence of carcinoid syndrome have been found to correlate with metastatic potential. Neither tumor necrosis nor local tumor invasion (into vessels, tunica albuginea, etc.) correlated with adverse prognosis. Carcinoid tumor of the testis is a rare indolent neoplasm with potential for distant metastases.
authors.affiliation: Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
authors.forename: A
authors.initials: A
authors.lastname: Zavala-Pompa
authors.forename: J Y
authors.initials: JY
authors.lastname: Ro
authors.forename: A
authors.initials: A
authors.lastname: el-Naggar
authors.forename: N G
authors.initials: NG
authors.lastname: Ordóñez
authors.forename: M B
authors.initials: MB
authors.lastname: Amin
authors.forename: P D
authors.initials: PD
authors.lastname: Pierce
authors.forename: A G
authors.initials: AG
authors.lastname: Ayala
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D002276:Carcinoid Tumor / Q000235:genetics* / Q000473:pathology* / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure; D003593:Cytoplasm / Q000648:ultrastructure; D003594:Cytoplasmic Granules / Q000648:ultrastructure; D004273:DNA, Neoplasm / Q000032:analysis*; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000473:pathology; D013736:Testicular Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000648:ultrastructure
chemical_list: D004273:DNA, Neoplasm; D017430:Prostate-Specific Antigen