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PubMed2003

Primary adenocarcinoma of the rete testis.

We report a case of adenocarcinoma of the rete testis in a 44-year-old man, presented intially with a hydrocele and later with signs of infection in the affected hemiscrotum. Multiple focal lesions within the testis appeared 6 months later in ultrasounds. After high inguinal orchiectomy, histology revealed a primary adenocarcinoma of the rete testis. Adenocarcinoma of the rete testis is a rare a highly malignant tumour originating in the mediastinum of the testis. Slightly over 40 cases have been reported in the literature. The treatment of choice is radical orchiectomy. Prognosis is poor; as mainly as 40% of patients die within the first year of diagnosis.

Adenocarcinoma↗

PubMed1984

Surgical technique to cannulate the rete testis of the goat.

A surgical technique was devised to collect rete testis fluid from 14 mature goats. The tubular portion of the extratesticular rete testis was cannulated where it penetrated the tunica albuginea of the testis under the center of the head of the epididymis. The tip of the cannula was sutured in place in the extratesticular rete testis and the opposite end was passed through the scrotum and into a plastic collection bottle. The bottle was glued to pillow ticking, which was sutured to the scrotum. Continuous flow of rete testis fluid occurred for 0 to 14 days and was usually terminated by a sperm clot in the cannula. The flow rate was 0.59 +/- 0.37 ml/hr.

Animals↗

PubMed1993

Ultrasound appearances of the rete testis.

Improved technology enables better visualization of normal anatomical structures. The rete testis is now visible as an ill-defined echo-poor region at the testicular hilum, sometimes with arboriform projections into the parenchyma. In a retrospective review of 100 cases of non-inflamed testes, the rete testis was seen in 18%. The anatomy was confirmed by scanning post-mortem specimens in a waterbath, marking the echo-poor region and then studying the histology. The spectrum of ultrasound appearances of the normal rete testis is presented. The rete testis can be distinguished easily from pathology because the parenchyma remains otherwise homogeneous and normal in appearance.

Humans↗

PubMed2002

Cystic ectasia of the rete testis: clinical and radiographic features.

PURPOSE: Cystic ectasia of the rete testis is a rare condition that may be incidentally noted on scrotal ultrasonography. This benign condition has a typical appearance of a collection of small anechoic structures in the confluence of the mediastinum testis. The main significance of this condition is that it must be differentiated from testicular neoplasm. We reviewed the experience with this condition at our institution. MATERIALS AND METHODS: A retrospective review was performed to identify all sonograms showing ectatic rete testis performed from 1998 through February 2002. A departmental database was used to identify all scrotal sonograms from this period showing ectasia of the rete testis and clinical correlation was done. These examinations were then reviewed by a single radiologist. RESULTS: We identified 13 cases in the last 4 years. Ultrasound was most commonly performed for a testicular or scrotal mass, or pain. Median patient age was 65 years. All except 1 patient had an underlying condition, including vasectomy, epididymal cyst/spermatocele or inguinal hernia repair, that could cause epididymal or efferent duct obstruction. No patient had a solid testicular mass. CONCLUSIONS: Based on clinical and sonographic criteria the diagnosis of cystic ectasia of the rete testis can be made without histological confirmation. Identifying this entity and its associated conditions avoids the need for biopsy or orchiectomy.

Adult↗

PubMed1989

Nodular proliferation of calcifying connective tissue in the rete testis: a study of three cases.

We report the first description of a bilateral rete testis lesion. The lesion was found in three adult men with histories of myocardium infarct or hemorrhage. The histologic study of the rete testis in these men revealed nodular sessile or pediculate formations which protruded into the rete testis channels. These polypoid formations consisted of an axis of connective tissue covered by a flattened epithelium. The axis contained a variable number of fibroblasts, areas with fibrin-like material, and small to large calcium deposits. Inflammatory infiltrates were neither observed in the rete testis nor in the testicular parenchyma. The testicular pattern varied from seminiferous tubules with complete spermatogenesis (two cases) to tubules with Sertoli cells and a few spermatogonia, surrounded by a thickened tunica propia. The term "nodular proliferation of calcifying connective tissue in the rete testis" is proposed to designate this lesion.

Aged↗

PubMed1988

Papillary adenocarcinoma of rete testis. Autopsy findings, histochemistry, immunohistochemistry, ultrastructure, and clinical correlations.

Adenocarcinoma of the rete testis is a rare neoplasm that usually occurs in men after the age of 60 and carries a variable prognosis. We report an occurrence of this tumor in a 91-year-old man who had been treated for 2 years for an hydrocele. At the time of diagnosis, metastases were not evident; and the patient was treated with local radiotherapy. The diagnosis of papillary adenocarcinoma of the rete testis was made on the basis of: (a) a transition from normal rete testis to atypical and neoplastic rete epithelium; (b) exclusion of primary germinal and nongerminal testicular tumors and spread from distant sources; and (c) electron-microscopic findings, histochemical and immunological studies, and autopsy findings supporting the diagnosis. This is the first reported case of adenocarcinoma of the rete testis that includes documentation of the tumor's metastatic pattern.

Adenocarcinoma, Papillary↗

PubMed1991

Adenomatous hyperplasia of the rete testis. A clinicopathologic study of nine cases.

Adenomatous hyperplasia of the rete testis is an uncommon lesion that has recently been described. Nine cases of adenomatous hyperplasia were identified in two institutions from 1980 to 1989. At diagnosis the nine patients ranged in age from 30 to 74 years (mean, 59 years; median, 66 years). Three patients presented with a grossly identifiable solid or cystic testicular hilar mass. In six cases adenomatous hyperplasia was an incidental microscopic finding--five from orchiectomy specimens and one from an autopsy specimen. Microscopically, the hyperplasia consisted of a tubulopapillary epithelial proliferation of rete testis. The lining cells were cuboidal to low columnar and lacked nuclear pleomorphism or mitotic figures. The involvement of the rete testis was predominantly diffuse. In seven cases the seminiferous tubules showed atrophic changes. Ultrastructural and immunohistochemical (keratin, epithelial-membrane antigen: positive; vimentin, muscle-specific actin, desmin, and S-100: negative) studies done on one case showed similar features to those of nonhyperplastic rete testis epithelium. No patient with adenomatous hyperplasia showed local recurrence or metastasis. Possible pathogeneses include hormonal imbalance or stimulatory influence that remains as yet unidentified.

Adenoma↗

PubMedDate not supplied

[Papillary adenocarcinoma of the rete testis. Report of a case].

OBJECTIVES: Another case of adenocarcinoma of the rete testis is described and the literature on this uncommon tumor type reviewed. METHODS/RESULTS: The clinical features, pathological findings and treatment of adenocarcinoma of the rete testis in a 72-year-old male are presented. CONCLUSIONS: Adenocarcinoma of the rete testis is a rare tumor type; few cases have been reported in the literature. Although treatment is primarily by surgery, recognition of new cases will provide further insight into this primary tumor of the rete testis.

Adenocarcinoma, Papillary↗

PubMed1984

Adenocarcinoma of the rete testis. Case report, ultrastructural observations, and clinicopathologic correlates.

Adenocarcinoma of the rete testis is a rare tumor that tends to occur in men over the age of 60 and is usually associated with a poor prognosis. We report such a tumor occurring in a 63-year-old male 2 years after he underwent a scrotal exploration in the management of a hydrocele, varicocele, and inguinal hernia. The postorchidectomy course was characterized by slowly advancing, painful scrotal and perineal skin recurrences, lymph node metastases, and the absence of response to Adriamycin and electron-beam therapy. We are confident that the lesion is a carcinoma of the rete testis because: 1) the tumor is situated mainly in the testicular mediastinum, 2) primary germinal and nongerminal testicular tumors and spread from distant sources have been excluded, 3) a transition from normal rete testis to atypical and neoplastic rete epithelium is demonstrable, and 4) the transmission electron-microscopic findings support our conclusion. The distinction between carcinoma of the rete testis and malignant mesothelioma may be difficult and requires consideration of the gross, light-microscopic, and ultrastructural tumor characteristics in optimally fixed tissue.

Adenocarcinoma↗

PubMed1991

Rete testis hyperplasia with hyaline globule formation. A lesion simulating yolk sac tumor.

The presence of eosinophilic, hyaline globules in association with epithelial hyperplasia was noted in the rete testis of three patients with germ cell tumors. In the more florid examples, this proliferation formed a solid and microcystic pattern that, in association with the hyaline globules, mimicked a yolk sac tumor component. However, the bland cytologic features of the cells and the conformation to the configuration of the rete testis were keys to its reactive nature. A subsequent review of 48 testicular specimens containing well-defined areas of the rete testis showed hyaline globule formation in the rete testis or tubuli recti in 16 of 27 germ cell tumors, one of five other testicular tumors (four stromal tumors and one plasmacytoma), and none of 16 nonneoplastic cases. Many of the cases that had hyaline globules also showed epithelial hyperplasia. Further analysis demonstrated an incidence of rete testis invasion by neoplasm in cases that had hyaline globules, with or without epithelial hyperplasia, that was significantly higher (p less than 0.01) than that seen in neoplastic cases lacking hyaline globules. We concluded that this pseudoneoplastic reaction developed secondary to invasion of the rete testis by tumor. Immunostains supported the nonneoplastic nature of the proliferative lesions and indicated that the globules represented various proteins that had been absorbed from the lumen of the rete testis by the epithelial-lining cells but not successfully secreted.

Albumins↗

PubMed1987

Biosynthesis and secretion of clusterin by ram rete testis cell-enriched preparations in culture.

Rabbit polyclonal antibodies, directed specifically against clusterin purified from ram rete testis fluid, were employed in an investigation of the biosynthesis of clusterin by cultures of rete testis epithelial cells and by Sertoli cells prepared from testes of adult rams. Cells in serum-free medium were incubated in the presence of either [35S]methionine, [3H]leucine, or [3H]glucosamine, and radiolabeled proteins secreted were immunoprecipitated. The pellet was subjected to polyacrylamide gel electrophoresis under reducing and non-reducing conditions, and the gels were then fluorographed. In other experiments, protein bands were transferred to nitrocellulose and visualized immunochemically. Under non-reducing conditions, a single band was detected, having a molecular weight of 80,000. Under reducing conditions, doublet bands were detected, having approximate molecular weights of 40,000 (major band) and 37,000 (minor band). These properties were indistinguishable from those obtained with authentic samples of pure clusterin subjected to gel electrophoresis and Western immunoblot procedures. Amounts of clusterin synthesized by rete testis cells in culture, quantitatively determined with a sandwich enzyme-linked immunosorbent assay procedure, were approximately 4 micrograms/micrograms cell DNA/48 h. Immunocytochemical localization investigations, using monoclonal antibodies against clusterin, revealed the presence of clusterin in the perinuclear of juxtanuclear regions, in both rete testis epithelial cells and Sertoli cells in culture. The possible functions of clusterin produced by rete testis epithelial cells and by Sertoli cells are discussed.

Animals↗

PubMed1983

Purification and characterization of a cell-aggregating factor (clusterin), the major glycoprotein in ram rete testis fluid.

Clusterin has been purified from ram rete testis fluid by conventional techniques and by immunoaffinity chromatography. The molecule is characterized as a glycoprotein having a molecular mass of approximately 80,000 Da and an isoelectric point of 3.6. The purified protein retains the capacity to elicit clustering of cells in an in vitro assay. Under reducing conditions in the presence of sodium dodecyl sulfate, clusterin dissociates into subunits of about 40,000 Da. Heterogeneities in apparent molecular mass were eliminated after treatment of clusterin with neuraminidase. Gel filtration chromatography revealed that clusterin exists in dimeric and tetrameric forms under conditions of neutral pH and low salt concentrations. In the presence of 6 M urea, only the monomeric form is evident, with an apparent molecular mass of approximately 85,000 Da. Clusterin, which was found to contain 4.5% glucosamine, binds to concanavalin A-Sepharose and also to wheat germ agglutinin Sepharose. The amino acid composition of clusterin is reported. The possible cellular source of clusterin in rete testis fluid is discussed. It is shown that Sertoli cells in the seminiferous tubule are one potential source, since primary cultures of rat Sertoli cells secrete a protein having the same immunochemical and physical properties as clusterin isolated from ram rete testis fluid. Possible functions of clusterin are discussed.

Amino Acids↗

PubMed1983

Ram rete testis fluid contains a protein (clusterin) which influences cell-cell interactions in vitro.

Ram rete testis fluid is shown to elicit clustering of suspensions of Sertoli cells from testes of immature rats, TM-4 cells derived from mouse testis, and erythrocytes from several species. Details of bioassay procedures and characteristics of the phenomenon are reported. Concanavalin A and wheat germ agglutinin prevent aggregation elicited by rete testis fluid, and this inhibition is specifically prevented by alpha-methylmannoside and N-acetyl-glucosamine, respectively. Influences of rete testis fluid on cell aggregation are not dependent on exogenous calcium, but clustering is blocked by various metabolic inhibitors such as dinitrophenol. Rete testis fluid addition to mixed suspensions of erythrocytes and TM-4 cells is followed by separate aggregation of each cell types. Using aggregation of TM-4 cells suspended in simple medium at low density in rotation as a bioassy, we have determined which fractions in rete testis fluid retain activity. We have shown that a heat-stable, trypsin-sensitive protein, having an isoelectric point below pH 4.0, retains the capacity to aggregate cells. We discuss the possible functions of this protein, named clusterin, in cell interactions.

Animals↗

PubMed2005

Cystic dysplasia of the rete testis. Case report.

Cystic dysplasia of the rete testis (CDRT) is a very rare cause of a paediatric scrotal mass often associated with renal and other genitourinary tract anomalies. These complex malformations are probably due to a developmental defect of the mesometanephric system during embryogenesis. A case of asymptomatic scrotal swelling in a 4-year-old boy is presented. Ultrasonography, showed a cystic lesion of the left testis associated with absence of the left kidney. Orchiectomy was performed because of extensive gonad involvement. Pathologic examination revealed multiple, anastomosing, irregular cystic spaces of varying sizes and shapes predominantly located in the region of the rete testis. The cysts had spread irregularly, displacing the testicular parenchyma, which was subsequently compressed under the tunica albuginea. Preoperative diagnosis of CDRT is easy if age, precise localisation, characteristic ultrasonographic features and other genitourinary malformations are considered. Other paediatric cystic lesions should be included in the differential diagnosis. It is possible to cure CDRT by orchiectomy or by conservative treatment. Nowadays the later option is preferred, but diagnosis of CDRT must be precisely established and followed by careful monitoring.

Child, Preschool↗

PubMed1997

Cystic dysplasia of the rete testis: a benign congenital lesion associated with ipsilateral urological anomalies.

PURPOSE: Cystic dysplasia of the rete testis is a benign congenital lesion that can mimic testicular cancer. We report 6 cases, review the literature, discuss the embryological etiology and make management recommendations. MATERIALS AND METHODS: The records and pathology reports of 6 boys presenting with cystic dysplasia of the rete testis at 5 institutions were reviewed, as was the relevant literature. RESULTS: Of the 6 cases 5 presented as scrotal masses in previously healthy boys and 1 as an abdominal mass in a newborn with multiple congenital anomalies. One patient had been followed from birth for a multicystic dysplastic kidney and 4 were found to have an ipsilateral absent kidney during evaluation. Development of the contralateral side was normal in most cases. CONCLUSIONS: Cystic dysplasia of the rete testis is an unusual, benign congenital lesion that can mimic testicular cancer in presentation. The presence of ipsilateral renal anomalies, particularly renal agenesis, can suggest cystic dysplasia of the rete testis in the differential diagnosis preoperatively. Even if cystic dysplasia of the rete testis is suspected, we recommend inguinal exploration and early control of the spermatic cord in the event that neoplasia is identified. If possible, the goal of preserving as much normal testicular parenchyma as possible is desirable. Long-term followup for possible recurrence is recommended, particularly after local excision.

Child↗

PubMed1994

Tubular ectasia of the rete testis.

Tubular ectasia of the rete testis is an uncommon entity that is usually discovered incidentally during ultrasound evaluation of epididymal abnormalities. The characteristic ultrasound appearance, its frequent association with spermatoceles and the lack of a palpable mass are the main features that permit identification of this entirely benign lesion.

Humans↗

PubMed2001

Congenital cystic dysplasia of the rete testis.

Cystic dysplasia of the rete testis (the network of straight seminiferous tubules within the mediastinum testis leading to the efferent ductules) is a rare congenital anomaly. There are only 15 cases reported in the literature to date and only one report of the US findings [1-5]. This report highlights the characteristic appearance of the lesion on ultrasound examination and its association with renal abnormalities in two patients.

Abnormalities, Multiple↗

PubMed1985

Lesions of the rete testis in mice exposed prenatally to diethylstilbestrol.

Adenocarcinoma of the rete testis is an exceptionally rare and malignant testicular neoplasm. Although treatment of pregnant women with diethylstilbestrol (DES) results in reproductive tract abnormalities in their male offspring, increased incidence of testicular tumors has not been verified. However, recently three cases of seminoma have been described in men prenatally exposed to DES, suggesting an association of prenatal DES treatment and the subsequent development of testicular tumors. This report describes the treatment of outbred pregnant CD-1 mice with DES (100 micrograms/kg) on Days 9 through 16 of gestation and its effects on their male offspring. In addition to nonmalignant abnormalities such as retained testes which have been reported in men exposed prenatally to DES, lesions resembling adenocarcinoma of the rete testis were seen in prenatally DES-treated mice at 10 to 18 mo of age (11 of 233; 5%). No comparable lesions were seen in 96 age-matched control male mice. These results suggest an association of prenatal DES exposure and the subsequent development of testicular lesions in the rete testis of mice.

Adenocarcinoma↗