title: Prostatic tissue in testicular teratoma. A clinicopathologic and immunohistochemical study.
abstract: The presence of prostatic differentiation as part of teratoma is very unusual and has been reported less than 20 times in the literature; however, all but 1 case were described in ovarian teratomas. We reviewed 45 specimens of germ cell tumors with teratoma component in postpuberal male patients. Original hematoxylin and eosin review failed to identify glands morphologically consistent with prostatic differentiation. Immunohistochemical stains performed on 10 specimens from 10 patients with small glandular and/or tubular structures revealed 1 case with glands positive for prostatic-specific antigen, prostatic-specific acid phosphatase, and prostein/P501S, whereas high-molecular-weight cytokeratin and p63 highlighted only basal cells. The glands were irregular in size and shape and contained mostly cuboidal to columnar luminal-type cells with occasional basal-type cells. Re-review of all the specimens revealed a second block from the same testis as well as 1 retroperitoneal lymph node with metastatic teratoma in the same patient, also immunohistochemically confirmed. These glands were seen in a smooth muscle stromal background, adjacent to classic gastrointestinal and tracheobronchial teratoma components. Our findings show immunohistochemically confirmed prostatic differentiation in 2 specimens from 1 patient with teratoma. This study raises the possibility that prostatic differentiation, difficult to recognize on morphology alone, might not be that unusual and that immunostains can help detect it over the several different epithelial components of teratoma.
authors.affiliation: Department of Anatomic Pathology, Pathology and Laboratory Medicine Institute, Cleveland Clinic, OH 44195, USA. romaa@ccf.org
authors.forename: Andres A
authors.initials: AA
authors.lastname: Roma
authors.forename: Peter A
authors.initials: PA
authors.lastname: Humphrey
mesh_terms: D000135:Acid Phosphatase; D000293:Adolescent; D000328:Adult; D002454:Cell Differentiation; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism; D008875:Middle Aged; D011467:Prostate / Q000378:metabolism* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D017027:Protein Tyrosine Phosphatases / Q000378:metabolism; D012189:Retrospective Studies; D013724:Teratoma / Q000378:metabolism / Q000473:pathology*; D013736:Testicular Neoplasms / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
chemical_list: D008565:Membrane Proteins; C422655:prostein; D000135:Acid Phosphatase; C428439:prostatic acid phosphatase; D017027:Protein Tyrosine Phosphatases; D017430:Prostate-Specific Antigen