PMC3638494_01
(a) Cross-sectional MRI shows peripheral enhancement of the lesion, which is clearly separate from the testis and demonstrates a central area of necrosis. (b) Cut surface of the specimen shows a yellow tumour mass with central necrosis.
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The MRI confirmed a 2.3 cm irregular lesion arising posterior to the lower pole of the right testis that enhanced peripherally with central necrosis and therefore could not rule out a potentially malignant lesion (Figure 1(a)). Sectioning revealed a 20 mm yellow, partly necrotic tumour mass (Figure 1(b)).
Coagulative necrosis in the central part of the tumour.
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Histological examination (H+E) showed a central area of coagulative necrosis with surrounding reactive fibroblastic tissue and inflammation (Figure 2).
Irregular nests of viable neoplastic cells.
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Irregular clusters and solid nests of viable epithelioid cells were present, partly obscured by the fibroblastic tissue reaction (Figure 3). 
Positive calretinin staining in the neoplastic cells.
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On immunohistochemical staining, these epithelioid cells were positive for CAM5.2 and CK7 and also expressed the mesothelial markers calretinin and WT1 (Figure 4).