Testicular tumor in a case of, undescended testes, persistent mullerian duct syndrome and transverse testicular ectopia: Report of a case and review of the literature

Abstract

A 20-year-old with normal male body features and secondary sexual characteristics presented with a right testicular swelling. Imaging revealed a right testicular mass, leading to a diagnosis of classical seminoma. During inguinal orchiectomy, a solid testicular mass was found on the right side along with two spermatic cords, one attached to the mass and the other to a structure resembling a testes. Examination showed the presence of other testes and a rudimentary uterus, indicating a rare case of a testicular tumor coexisting with undescended testes and transverse testicular ectopia (TTE) in a Pseudohermaphrodite with "persistent mullerian duct syndrome" (PMDS).

Keywords: Disorder of sexual differentiation; Persistent mullerian duct; Testicular tumor; Transverse testicular ectopia.

Fig. 1

Axial views of the CT scan abdomen and pelvis with IV and Oral contrast. Showing huge heterogeneous solid retroperitoneal par aortic lymph nodes mass with Central necrosis.

Fig. 2

Axial views of the MRI scan abdomen and pelvis with contrast. Showing the RT low signal intesity (T1W1-T2W2) testicular mass and huge heterogeneous solid retroperitoneal par aortic lymph nodes mass with Central necrosis.

Fig. 3

Gross Specimen of the RT testicular exophytic whitish mass typical of Seminoma (300 gm), with sperrmatic cord (3cm), scrotal sac (looks like Uterus, 4cm), and LT testes impeded within the tumor (1.5cm).

Fig. 4

Microscopic slides of the histopathological specimen, showing Sheets of uniform tumor cells, divided by poorly demarcated lobules of fibrous septa with lymphocytes and plasma cells. Tumor cells are large, round and polyhedral with distinct cell borders, abundant clear cytoplasm large Central nuclei and prominent nucleoli. Central necrosis identified with Evidence of lymph vascular invasion and intratubular germ cell neoplasia.