Benign müllerian glandular inclusions in men undergoing pelvic lymph node dissection

Area of Science:

• Pathology
• Urology
• Oncology

Background:

• Benign müllerian-type glandular inclusions are common in women but rarely reported in men.
• Accurate differentiation from metastatic adenocarcinoma is critical for patient management.

Purpose of the Study:

• To report and characterize benign müllerian-type glandular inclusions in male patients.
• To confirm the müllerian origin of these inclusions using immunohistochemical markers.

Main Methods:

• Retrospective analysis of 3 male cases with lymph node dissection for genitourinary malignancies.
• Immunohistochemical staining for PAX-8, WT-1, estrogen receptor, and progesterone receptor.

Main Results:

• Three cases of benign müllerian-type glandular inclusions were identified in men.
• Glands showed benign morphology with ciliated cells, positive for PAX-8, WT-1, ER, and PR, confirming müllerian origin.
• This is the first study to confirm müllerian origin using PAX-8 and WT-1 positivity in men.

Conclusions:

• Benign müllerian-type glandular inclusions can rarely occur in men, similar to endosalpingiosis in women.
• These findings support müllerian metaplasia of the peritoneal mesothelium as the origin.
• Awareness is crucial for pathologists to avoid misdiagnosis of metastatic adenocarcinoma.