The clinicopathologic features of 118 granular cell tumors (GCT) encountered at two affiliated hospitals were reviewed. A total of 110 patients were affected over this 32-year period of study (71 men, 39 women), and in 5% GCT were multiple. Patients ranged in age from 16 to 58 years (average 32 years) and were symptomatic for an average duration of 11 months prior to diagnosis. There was a greater than expected frequency of GCT among black patients (29%). Although tongue was the single most common anatomic site involved, relatively more GCT (44%) occurred in skin or subcutaneous tissue. Less common locations were breast parenchyma (10 cases), rectal mucosa and anus (6), vulva (4), esophagus and larynx (2 cases each). The correct preoperative diagnosis of this protean tumor was made in only three patients. GCT were surgically treated with the average diameter of resected tumor being 1.2 cm (range 0.2--3.5 cm). Pseudoepitheliomatous hyperplasia was noted in 11 tumors and in one vulvar GCT there was overlying in situ squamous cell carcinoma. Tumors were incompletely excised in 24 of 56 patients having adequate followup; only five of these 24 patients experienced a local recurrence of tumor. Malignant behavior was not observed. Results of histochemical and ultrastructural study are briefly discussed. The precise histogenesis of GCT is uncertain but Schwann cell origin is favored in most cases.

Epidermoid cysts of the testis are rare and represent about 1% of all testicular tumors. An analysis of 141 cases reported to date in the world literature, including the cases reported here, indicates that 50% of the lesions occur in the third decade and 86% between the second and fourth decade. The most common presentations are painless enlargement of the testis (41%) for an average period of 2.25 years or incidental detection during routine physical examination (33%). Clinically, a discrete testicular nodule can be palpated in the majority of the cases (76%). Pathologic findings are those of a squamous lined cyst containing keratin with absence of appendages or other elements. It is believed that, despite the benign nature of the lesion, they should be treated by orchiectomy so that a thorough pathologic examination can be done to establish a confident diagnosis. While some controversy exists about their source of origin, all the evidence, including the age, more common occurrence among whites, and the rare reported cases arising in cryptorchid testis points to a germ cell origin for these lesions. The epidermoid cyst should thus be recognized as another subtype in the category of germ cell tumors of the testis and perhaps the ovary.Cancer 47577-582, 1981. H E MAJORITY O F TESTICULAR TUMORS, nearly 95%T of them, are germ cell in origin, and almost all of these are malignant. The rarer, benign tumors of the testis are accounted for mainly by tumors of the specialized gonadal stroma, the supporting connective tissue, the dermoid, and epidermoid cysts. While the dermoid cyst, analogous to its more common counterpart in the ovary, is extremely rare in the testis, it appears from the scattered reports that epidermoid cysts may not be all that rare.29 In fact, it is estimated that epidermoid cysts represent about 1% of all testicular tumors and are perhaps as common as the benign interstitial tumor of the t e s t i~.~~~"~~ We report three cases of epidermoid cysts of the testis, which were seen within a two-year period at Georgetown University Medical Center. A review of other cases reported in the world literature delineates the clinical and pathologic features and offers further evidence on their likely origin. Case Reports Case IA 24-year-old white male consulted a physician after he felt enlargement of the right testis. Physical examination revealed a slight swelling of the right epididymis and also a 1 cm painless and nontender mass in the left testis. The patient denied any knowledge of the mass but admitted to a history of gonorrhea 2% years previously. Due to a suspicion of a testicular tumor, a left orchiectomy with high ligation of the cord was carried out. Exploration of the right side showed a cyst ofthe epididymis that was opened and drained. Three-and-a-half years later, the patient is alive and well.Pathologic examination showed a well-circumscribed 1.1 cm nodule within the testicular parenchyma, filled with flaky, yellow-white material. Part of the wall was calcified. Microscopically, the cyst was fil...

No abstract

Epidermoid cysts of the testis are rare and represent about 1% of all testicular tumors. An analysis of 141 cases reported to date in the world literature, including the cases reported here, indicates that 50% of the lesions occur in the third decade and 86% between the second and fourth decade. The most common presentations are painless enlargement of the testis (41%) for an average period of 2.25 years or incidental detection during routine physical examination (33%). Clinically, a discrete testicular nodule can be palpated in the majority of the cases (76%). Pathologic findings are those of a squamous lined cyst containing keratin with absence of appendages or other elements. It is believed that, despite the benign nature of the lesion, they should be treated by orchiectomy so that a thorough pathologic examination can be done to establish a confident diagnosis. While some controversy exists about their source of origin, all the evidence, including the age, more common occurrence among whites, and the rare reported cases arising in cryptorchid testis points to a germ cell origin for these lesions. The epidermoid cyst should thus be recognized as another subtype in the category of germ cell tumors of the testis and perhaps the ovary.