Annals of Diagnostic Pathology 18 (2014) 191
Contents lists available at ScienceDirect
Annals of Diagnostic Pathology
Letter to the Editor
Prostatic tissue in testicular teratoma To the Editor: We read the interesting article of Roma and Humphrey [1] published in February 2013 edition of Annals of Diagnostic Pathology reporting the presence of prostatic tissue in testicular teratoma. The authors mentioned that the presence of prostatic tissue in teratomas was very unusual and had been reported in the literature for about 20 times. They claimed that all these teratomas were ovarian except the one that was the case reported by Unger et al [2]. Unfortunately, Roma and Humphrey [1] lacked giving the information about our article on the prostate tissue in a testicular teratoma in their article. We previously reported the presence of prostatic tissue in the teratoma component of a mixed malignant germ cell tumor of the testis [3]. The prostatic tissue was composed of acinar and ductal structures within a fibromuscular stroma. These epithelial structures were prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) positive immunohistochemically. The presence of basal cells was confirmed by p63 and 34BE12 staining. Prostatic glands partially showed clear cell cribriform hyperplasia. There was no sign of malignancy. Roma and Humphrey [1] reported that there were a few glandular structures lacking basal high-molecular-weight cytokeratin staining, which is a finding, as the authors stated, that it was too speculative to conclude about malignancy. On the other hand, Halabi et al [4] reported the presence of Gleason grade 3 prostatic adenocarcinoma areas in which they confirmed the lack of basal cells in an ovarian teratoma. Clear cell cribriform hyperplasia in our case, the findings raising the prostatic adenocarcinoma suspicion in the case of Roma and Humphrey [1], and the prostatic adenocarcinoma area in the ovarian
http://dx.doi.org/10.1016/j.anndiagpath.2014.01.004 1092-9134/© 2014 Elsevier Inc. All rights reserved.
teratoma reported by Halabi et al [4] are all good examples of the lesion spectrum of prostate tissue originating in teratomas, either testicular or ovarian. In conclusion, we wanted you to be aware of our previously published case, which was the second example of a prostate tissue within a testicular teratoma in literature, and also wanted to remind the morphologic spectrum of this teratomatous prostatic tissue. I. Kilicaslan, MD M.G. Gulluoglu, MD Y. Ozluk, MD E. Onat, MD E. Cakir, MD Department of Pathology, Istanbul Faculty of Medicine Istanbul University Istanbul, Turkey E-mail address: [email protected]
References [1] Roma AA, Humphrey PA. Prostatic tissue in testicular teratoma. A clinicopathologic and immunohistochemical study. Ann Diagn Pathol 2013;17:10–3. [2] Unger PD, Cohen EL, Talerman A. Mixed germ cell tumor of the testis. J Urol Pathol 1998;9:257–63. [3] Kilicaslan I, Gulluoglu M, Ozluk Y, Onat E, Cakir E. Prostate tissue within teratoma component of malignant mixed germ cell tumor. Int J Surg Pathol 2010;18:339–40. [4] Halabi M, Oliva E, Mazal PR, Breitenecker G, Young RH. Prostatic tissue in mature cystic teratoma of the ovary: a report of four cases, including one with features of prostatic adenocarcinoma, and cytogenetic studies. Int J Gynecol Pathol 2002;21:261–7.
Contents lists available at ScienceDirect
Annals of Diagnostic Pathology
Letter to the Editor
Prostatic tissue in testicular teratoma To the Editor: We read the interesting article of Roma and Humphrey [1] published in February 2013 edition of Annals of Diagnostic Pathology reporting the presence of prostatic tissue in testicular teratoma. The authors mentioned that the presence of prostatic tissue in teratomas was very unusual and had been reported in the literature for about 20 times. They claimed that all these teratomas were ovarian except the one that was the case reported by Unger et al [2]. Unfortunately, Roma and Humphrey [1] lacked giving the information about our article on the prostate tissue in a testicular teratoma in their article. We previously reported the presence of prostatic tissue in the teratoma component of a mixed malignant germ cell tumor of the testis [3]. The prostatic tissue was composed of acinar and ductal structures within a fibromuscular stroma. These epithelial structures were prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) positive immunohistochemically. The presence of basal cells was confirmed by p63 and 34BE12 staining. Prostatic glands partially showed clear cell cribriform hyperplasia. There was no sign of malignancy. Roma and Humphrey [1] reported that there were a few glandular structures lacking basal high-molecular-weight cytokeratin staining, which is a finding, as the authors stated, that it was too speculative to conclude about malignancy. On the other hand, Halabi et al [4] reported the presence of Gleason grade 3 prostatic adenocarcinoma areas in which they confirmed the lack of basal cells in an ovarian teratoma. Clear cell cribriform hyperplasia in our case, the findings raising the prostatic adenocarcinoma suspicion in the case of Roma and Humphrey [1], and the prostatic adenocarcinoma area in the ovarian
http://dx.doi.org/10.1016/j.anndiagpath.2014.01.004 1092-9134/© 2014 Elsevier Inc. All rights reserved.
teratoma reported by Halabi et al [4] are all good examples of the lesion spectrum of prostate tissue originating in teratomas, either testicular or ovarian. In conclusion, we wanted you to be aware of our previously published case, which was the second example of a prostate tissue within a testicular teratoma in literature, and also wanted to remind the morphologic spectrum of this teratomatous prostatic tissue. I. Kilicaslan, MD M.G. Gulluoglu, MD Y. Ozluk, MD E. Onat, MD E. Cakir, MD Department of Pathology, Istanbul Faculty of Medicine Istanbul University Istanbul, Turkey E-mail address: [email protected]
References [1] Roma AA, Humphrey PA. Prostatic tissue in testicular teratoma. A clinicopathologic and immunohistochemical study. Ann Diagn Pathol 2013;17:10–3. [2] Unger PD, Cohen EL, Talerman A. Mixed germ cell tumor of the testis. J Urol Pathol 1998;9:257–63. [3] Kilicaslan I, Gulluoglu M, Ozluk Y, Onat E, Cakir E. Prostate tissue within teratoma component of malignant mixed germ cell tumor. Int J Surg Pathol 2010;18:339–40. [4] Halabi M, Oliva E, Mazal PR, Breitenecker G, Young RH. Prostatic tissue in mature cystic teratoma of the ovary: a report of four cases, including one with features of prostatic adenocarcinoma, and cytogenetic studies. Int J Gynecol Pathol 2002;21:261–7.
