Papillary Clear Cell Cystadenoma of the Epididymis

Chan, Y.-F.; Schinella, Roger; Draper, John W.

doi:10.1016/s0022-5347(17)62592-8

Cited by 15 publications

(3 citation statements)

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“…The origin of ECA has been a subject of debate. Previously documented large tumours involved a variety of anatomical sites and several anatomical sites of origin have been proposed, including epididymal ducts 25, 26, 43–46, efferent ductules 34, 44, 47, 48, spermatic cord 45, spermatocoele epithelium 25, 42 and vestigial testicular structures, such as testicular appendix, epididymal appendix, aberrant ductular structures and paradidymis 42. The atypical epithelial proliferations described in the current study, however, were exclusively confined to the efferent ductular system.…”

Section: Discussioncontrasting

confidence: 45%

Epididymal cystadenomas and epithelial tumourlets: effects of VHL deficiency on the human epididymis

Gläsker

Tran

Shively

et al. 2006

The Journal of Pathology

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Although epididymal cystadenomas (ECAs) are among the most frequent VHL disease-associated tumours, fundamental questions about their pathogenesis have remained unanswered. Classification of ECAs is controversial, and the cell of origin is unknown. It is also unknown whether ECAs-like other VHL disease-associated tumours-arise as a result of VHL gene inactivation, and whether ECAs exhibit subsequent activation of hypoxia-inducible factor HIF. Moreover, the morphological spectrum of earliest ECA formation is unknown. In a detailed molecular pathological analysis of a series of epididymides collected from VHL patients at autopsy, we found that ECAs are true neoplasms that arise secondary to inactivation of the wild-type copy of the VHL gene, followed by early and simultaneous activation of HIF1 and HIF2 associated with up-regulation of downstream targets, including CAIX and GLUT-1. The observations also indicate that ECA formation evolves from a variety of microscopic epithelial tumourlets, and that these tumourlets are confined to the efferent ductular system. Although genetic and immunohistochemical analysis of precursor structures consistently revealed VHL gene inactivation and activation of HIF in the precursor lesions, only a small subset appears to progress into frank cystadenoma. Thus, ECA tumorigenesis in VHL disease shares fundamental principles with tumorigenesis in other affected organ systems.

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Section: Discussioncontrasting

confidence: 45%

Epididymal cystadenomas and epithelial tumourlets: effects of VHL deficiency on the human epididymis

Gläsker

Tran

Shively

et al. 2006

The Journal of Pathology

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“…The cysts are derived from the efferent duct epithelium. Papillae grow inside the cysts and sometimes occupy the whole cystic lumen [105,106] (Figs. 12.33-12.35).…”

Section: Papillary Cystadenoma Of the Epididymismentioning

confidence: 99%

Perspectives in Pediatric Pathology, Chapter 12. Congenital Epididymal Anomalies

et al. 2016

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Congenital anomalies of the epididymis are frequent. Their understanding requires familiarity with their embryological origins. They are important given their impact on fertility. INTRODUCTION. EMBRYOLOGIC REMARKS John Hunter (1728-1793), the great Scottish surgeon whose many contributions advanced medicine in general and pathology in particular, was among the first to provide detailed descriptions of the male genital system in many species, including his elegant account of absent ductus deferens in a man: ''In dissecting a male subject, in the year 1755, for a side view of the contents of the pelvis, I found a bag on the left side, lying contiguous to the peritonaeum, just on the side of the pelvis where the internal iliac vessels divide above the angle of reflection of the peritonaeum at the union of the bladder and rectum. The left vas deferens was seen passing on to this bag; and what is very singular, that of the right, or opposite side, crossed the bladder, near its union with the rectum, to join it. I traced the left vas deferens down to the testicle; but, on following the right through the ring of the external oblique muscle, I discovered that it terminated at once, about an inch from its passage out of the abdomen, in a blunt point, which was impervious. On examining the spermatic chord from this point to the testicle, I could not find any vas deferens; but, by beginning at the testicle, and tracing the epididymis from its origin, about halfway along where it lies upon the body of the testicle, I perceived that it at first became straight, and soon after seemed to terminate in a point" [1]. Malformations of sperm excretory ducts have been recorded in the medical literature for more than two centuries. Mainly in the last two decades has interest in this field increased, thanks to new medical developments. These include a more complete assessment of infertile patients and modern techniques, such as transrectal

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“…A few case reports on lesions of the efferent ductules of the epididymis have been documented. There is a general consensus that epididymal papillary cystadenoma, a glandular, papillary cystic lesion with typically tall columnar ciliated cells, originates from efferent ductal epithelium (Sherrick, 1956;Grant and Hoffman, 1963;Shan et al, 1968). This rare lesion is wellknown to be related to von Hippel-Lindau (VHL) disease, although sporadic cases unrelated to VHL have been reported (Kallie et al, 1983).…”

Section: Inflammatory Conditions Of the Efferent Ductulesmentioning

confidence: 99%

Epididymitis and Other Inflammatory Conditions of the Male Excurrent Ductal System

Chan

2002

The Epididymis: From Molecules to Clinical Practice

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Physiologically, the endocrinologic interplay between testes and pituitary gland results in the production of spermatozoa. Before serving their role in fertilizing oocytes, spermatozoa must exit the testis and pass through a complex excurrent ductal system that includes the efferent ductules, epididymis, and vas deferens, which leads to the ejaculatory duct. Pathological conditions in any part of the excurrent ductal system obviously may have a significant effect on spermatozoa transport, resulting in subfertility or infertility. In addition to spermatozoa, semen is composed of secretions from a series of glandular organs, including the prostate, seminal vesicles, the bulbourethral (Cowper) gland and periurethral (Littré) gland. Collectively, these organs are known as the male accessory glands.Various inflammatory conditions, including microbial infection, are by far the most common pathology encountered in the male reproductive system. The term male accessory gland inflammation 1 describes a broad spectrum of inflammatory conditions involving the male accessory glands. The prostate gland and the seminal vesicles together produce about 90% of the ejaculate volume. Although inflammatory conditions of these organs (prostatitis and seminal vesiculitis) are important clinical topics in andrology (Weidner et al, 1998a,b), in this review our discussion will focus mainly on the various inflammatory conditions of the excurrent ductal system. In Part I of this review, our discussion will focus mainly on the various inflammatory conditions of the epididymis and efferent ductile. In Part II, we will discuss the rarely described subject of vasitis and address the management issues and fertility effects of excurrent ductal inflammation.

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Papillary Clear Cell Cystadenoma of the Epididymis

Cited by 15 publications

References 1 publication

Epididymal cystadenomas and epithelial tumourlets: effects of VHL deficiency on the human epididymis

Epididymal cystadenomas and epithelial tumourlets: effects of VHL deficiency on the human epididymis

Perspectives in Pediatric Pathology, Chapter 12. Congenital Epididymal Anomalies

Epididymitis and Other Inflammatory Conditions of the Male Excurrent Ductal System

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