Adenocarcinoma of the rete testis. Report of two cases

Adenocarcinoma of the rete testis is extremely rare and has been the subject of only sporadic case reports. Its natural history appears highly malignant even in localized forms; because of a poor response to adjuvant therapy radical orchiectomy with retroperitoneal lymph node dissection is recommended in stage A. We report our experience with two examples which arose in men of 26 and 57 years of age between 1988 and 1999. Both of them presented with a scrotal mass, and one of them had hydrocele. Neither had a history of maldescendent, infections or trauma. Microscopically the tumors were adenocarcinomas, and the one in the 26 years old patient presented with tubulopapillary formations. Immunohistochemical staining demonstrated positivity for CK and NSE in the 26 year old patient and only a weak positivity for CEA and vimentin in the 57 year old one. EMA and calretinin were always negative. Both were stage A but the young man who underwent radical orchiectomy with no lymph node dissection, developed a lymph node metastasis within one year.