title: Handling and reporting of orchidectomy specimens with testicular cancer: areas of consensus and variation among 25 experts and 225 European pathologists.
abstract: OBJECTIVE
  The handling and reporting of testicular tumours is difficult due to their rarity.
  
  
  RESULTS
  A survey developed by the European Network of Uro-Pathology (ENUP) and sent to its members and experts to assess the evaluation of testicular germ cell tumours. Twenty-five experts and 225 ENUP members replied. Areas of disagreement included immaturity in teratomas, reported by 32% of experts but 68% of ENUP. Although the presence of rete testis invasion was reported widely, the distinction between pagetoid and stromal invasion was made by 96% of experts but only 63% of ENUP. Immunohistochemistry was used in more than 50% of cases by 68% of ENUP and 12% of experts. Staging revealed the greatest areas of disagreement. Invasion of the tunica vaginalis without vascular invasion was interpreted as T1 by 52% of experts and 67% of ENUP, but T2 by the remainder. Tumour invading the hilar adipose tissue adjacent to the epididymis without vascular invasion was interpreted as T1: 40% of experts, 43% of ENUP; T2: 36% of experts, 30% of ENUP; and T3: 24% of experts, 27% of ENUP.
  
  
  CONCLUSIONS
  There is remarkable consensus in many areas of testicular pathology. Significant areas of disagreement included staging and reporting of histological types, both of which have the potential to impact on therapy.
authors.affiliation: Barts Cancer Institute, Queen Mary University of London, London, UK.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Berney
authors.affiliation: Fundacio Puigvert-University Autonomous, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Algaba
authors.affiliation: Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Mahul
authors.initials: M
authors.lastname: Amin
authors.affiliation: Department of Pathology, Wellington School of Medicine and Health Sciences and University of Otago, Wellington, New Zealand.
authors.forename: Brett
authors.initials: B
authors.lastname: Delahunt
authors.affiliation: Hôpital La Pitié-Salpetrière, Paris, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Compérat
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
authors.affiliation: Yale School of Medicine, Yale-New Haven Hospital, New Haven, CT, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Humphrey
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine and Indiana Pathology Institute, Indianapolis, IN, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Idrees
authors.affiliation: Cordoba University Medical School, Cordoba, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lopez-Beltran
authors.affiliation: Robert J Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Magi-Galluzzi
authors.affiliation: Institute of Pathology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Gregor
authors.initials: G
authors.lastname: Mikuz
authors.affiliation: Polytechnic University of the Marche Region, Ancona, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Montironi
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Oliva
authors.affiliation: Department Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Srigley
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Victor E
authors.initials: VE
authors.lastname: Reuter
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada.
authors.forename: Kiril
authors.initials: K
authors.lastname: Trpkov
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine and Indiana Pathology Institute, Indianapolis, IN, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Ulbright
authors.affiliation: University Hospital of Wales, Cardiff, UK.
authors.forename: Murali
authors.initials: M
authors.lastname: Varma
authors.affiliation: Department of Cellular Pathology, John Radcliffe Hospital, Oxford, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Verrill
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Young
authors.affiliation: Department of Pathology, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhou
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
mesh_terms: D032921:Consensus; D005060:Europe; D005104:Expert Testimony; D006801:Humans; D007150:Immunohistochemistry / Q000706:statistics & numerical data; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D009373:Neoplasms, Germ Cell and Embryonal / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D015588:Observer Variation; D009919:Orchiectomy; D013048:Specimen Handling / Q000379:methods; D011795:Surveys and Questionnaires; D013736:Testicular Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
keywords: classification; consensus; germ cell tumour; rete testis; staging; testis