Histologic Changes

Gross examination: The testis weighed 412 g and measured 11 x 8 x 7 cm. Normal testicular tissue was completely replaced by partly necrotic and hemorrhagic tumor, 9.5 x 6.5 x 4.5 cm. It did not invade the capsule of the testis (tunica albuginea), but appeared to involve the spermatic cord.

Several patterns are present in the tumor. The pattern shown here has peculiar structures that consist of an epithelial layer surrounding a small blood vessel (the Schiller-Duval body). This vascular-epithelial complex is a polyp in a space surrounded by flat tumor cells (large arrow).

The remainder of the tumor is composed of vascular connective tissue and tumor cells growing in clusters, single file, or microcysts (small arrow).

Other parts of the tumor have a solid growth pattern with a few microcysts and thin-walled vessels (upper left).

Large areas of tumor necrosis were present in other areas.

Cytoplasmic or extracellular hyaline droplets are a characteristic feature of this tumor. Note the large number and varying size of droplets at the upper left (arrow indicates one). By immunohistochemistry, some contain alpha-fetoprotein.

Note the microcysts formed by the tumor (lower mid-portion of photo).

Clinical summary Image 2

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