Pathology of Testicular and Penile Neoplasms

Pathology of Testicular and Penile Neoplasms

Maurizio Colecchia Editor Pathology of Testicular and Penile Neoplasms

Editor Maurizio Colecchia Department of Pathology Fondazione IRCCS Istituto dei Tumor Milan, Italy ISBN 978-3-319-27615-1 DOI 10.1007/978-3-319-27617-5 ISBN 978-3-319-27617-5 (ebook) Library of Congress Control Number: 2016936098 Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland

To Mariangela and Matteo for their patient, silent, and loving support and to my parents

Preface As editor of Pathology of Testicular and Penile Neoplasms, I would like to briefly explain the inspiration for this book, which came from a sentence I read in the Treasure Gallery of the British Library: Science depends on the accurate observation, collection and recording of information. This sentence (attributed to Galileo, the father of scientific observation) is the leitmotif in this book on penile and testicular neoplasms rare tumors which are, however, increasing in frequency and whose epidemiological implications will be illustrated here in light of the most recent knowledge in the field. Congenital testicular lesions, impaired spermatogenesis, cryptorchidism, Klinefelter syndrome, testicular dysgenesis, entities contributing to infertility and their correlation with an increased risk of cancer, and childhood and prepubertal germ cell tumors will be discussed. The book will also describe the precursor lesions of invasive cancer as well as the staging criteria that provide the clinician with information for the correct treatment of metastatic disease. Furthermore, with the aid of summary tables, it will illustrate the main differential diagnoses between morphological entities. One chapter will be dedicated to the use of intraoperative frozen section analysis, which is increasingly being requested for the diagnosis of ultrasound-detected small testicular lesions. As a practical handbook for pathologists, this volume will be an aid to the diagnosis of these uncommon tumors and to dealing with the diagnostic pitfalls they often present. The text will provide updates on the new editions of the classification systems for testicular and penile tumors, with a view to achieving the necessary clarity in the terminology used by the pathologist in communicating diagnostic information. It aims to familiarize also less experienced pathologists with the sampling methods for orchiectomy and penectomy specimens and with the appropriate recording of pathology findings according to the guidelines approved by the International Society of Urological Pathology (ISUP). The book is designed to provide practitioners with the tools and knowledge to formulate a complete histopathology report with all the necessary information for the clinician. Its contents reflect the experience of the authors of the various chapters (11 on testicular cancer, 3 on cancer of the penis) in light of the recent literature, documented by more than 250 photographs; we have scrutinized the currently available information in an attempt to provide valuable updates on the variants of penile carcinoma, HPV-related and unrelated penile tumors, and newly classified testicular neoplasms. The images have not been published before, and I am deeply vii

viii Preface grateful to the authors and coauthors of Pathology of Testicular and Penile Neoplasms, who have contributed their personal cases, giving their time and energy to the drafting of the chapters of this book, which I hope you will enjoy reading. Milan, Italy Maurizio Colecchia

Acknowledgements Many people have helped me get this book into shape. The contributions of Alessia Bertolotti, PhD, in all stages of its development and in the technical preparation of the slides (recutting, immunohistochemical staining, scanning of interesting cases) were irreplaceable. Biagio Paolini, MD, has improved the photomicrographs through refined color enhancement. His efforts in standardizing the appearance of the illustrations will surely be appreciated by our readers. I also gratefully acknowledge the work of Alessio Pellegrinelli, MD, who has shown surprising versatility in designing tables and drawing illustrations to make the macroscopic images of Chap. 13 easier to understand. I thank Drs Bandieramonte, Torelli, and Catanzaro for having contributed with the macroscopic images of penile lesions from their clinical activity. Special thanks go to Marije de Jager for meticulously correcting the manuscript. I am particularly grateful for her help in uniforming the style across chapters. Thanks go as well to Paolo Castioni and Maria Morelli, who have enthusiastically contributed to this book in various ways. I express my heartfelt appreciation to the library staff of Fondazione IRCCS Istituto Nazionale dei Tumori and in particular to Rossella Ballarini. Finally, I gratefully remember the teachings of Professor Juan Rosai (hoping they shaped me) that directed me and many other pathologists to a methodical approach in diagnostic pathology. Maurizio Colecchia ix

Contents Part I Testicular Tumors: Epidemiology 1 Epidemiology of Testicular Cancer......................... 3 Gemma Gatta and Annalisa Trama Part II Tumors of the Testis and Paratesticular Structures 2 Congenital Lesions..................................... 21 Manuel Nistal and Pilar González-Peramato 3 Entities Contributing to Infertility and Their Relationship to Oncogenic Risk...................................... 49 Manuel Nistal and Pilar González-Peramato 4 Germ Cell Tumors of Infancy and Childhood............... 69 Manuel Nistal and Pilar González-Peramato 5 The Stem Cell Origin and Pathogenetic Routes of Testicular Germ Cell Tumors.......................... 91 Maurizio Colecchia, Alessia Bertolotti, Biagio Paolini, and Gregor Mikuz 6 Tumors of the Testis.................................... 97 Gregor Mikuz and Maurizio Colecchia 7 Prognostic and Predictive Factors in Pathology of the Testis.......................................... 159 Nicola Nicolai 8 Handling of the Surgical Specimen and Pathology Reporting of Malignant Germ Cell and Sex Cord-Stromal Tumors of the Testis....................... 165 Marina Scarpelli, Roberta Mazzucchelli, Matteo Santoni, Valeria Sotte, Alessandro Conti, Antonio Lopez-Beltran, Liang Cheng, and Rodolfo Montironi 9 Cysts and Epithelial Proliferations of the Testicular Collecting System....................... 171 Antonio Lopez-Beltran, Rita Canas-Marques, Maria R. Raspollini, Rodolfo Montironi, Marina Scarpelli, and Liang Cheng xi

xii Contents 10 Paratesticular Soft Tissue Neoplasms..................... 191 Alessandro Franchi, Raffaella Santi, and Gabriella Nesi 11 Frozen Section in Testicular Pathology.................... 203 Maurizio Colecchia and Nicola Nicolai Part III Pathology of Precancerous Lesions and Tumors of the Penis 12 Precancerous Lesions of the Penis........................ 215 Maurizio Colecchia and Biagio Paolini 13 Tumors of the Penis and Scrotum........................ 229 Maurizio Colecchia, Alessia Bertolotti, Biagio Paolini, and Roberto Salvioni 14 Handling of the Surgical Specimen and Pathology Reporting of Penile Neoplasms.......................... 275 Rodolfo Montironi, Roberta Mazzucchelli, Matteo Santoni, Valeria Sotte, Antonio Lopez-Beltran, Liang Cheng, and Marina Scarpelli Index.................................................... 281

Contributors Alessia Bertolotti Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy Rita Canas-Marques Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal Liang Cheng Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA Maurizio Colecchia Uropathology Unit, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy Alessandro Conti Department of Odontostomatologic and Specialized Clinical Sciences, Section of Urology, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy Alessandro Franchi Division of Pathological Anatomy, University of Florence, Florence, Italy Gemma Gatta Evaluative Epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy Pilar González-Peramato Department of Pathology, Autonoma University of Madrid, Hospital Univ. La Paz., Madrid, Spain Antonio Lopez-Beltran Department of Pathology and Surgery, Faculty of Medicine, University of Cordoba, Cordoba, Spain Roberta Mazzucchelli Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy Gregor Mikuz Institute of Pathology, Medical University of Innsbruck, Innsbruck, Austria Rodolfo Montironi Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy Gabriella Nesi Division of Pathological Anatomy, University of Florence, Florence, Italy Nicola Nicolai Testis Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy xiii

xiv Contributors Manuel Nistal Department of Anatomy, Histology and Neuroscience, Autonoma University of Madrid, Madrid, Spain Biagio Paolini Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy Maria R. Raspollini Division of Histology and Molecular Diagnostics, University Hospital Careggi, University of Florence, Florence, Italy Roberto Salvioni Urology Unit, Fondazione IRCCS Istituto dei Tumori di Milano, Milan, Italy Raffaella Santi Division of Pathological Anatomy, University of Florence, Florence, Italy Matteo Santoni Medical Oncology, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy Marina Scarpelli Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy Valeria Sotte Medical Oncology, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy Annalisa Trama Evaluative Epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy