PMC6874974_01
CT of the abdomen and pelvis: enlarged contents of the left hemiscrotum with calcifications (arrow).
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The left hemiscrotum showed enlarged contents with calcifications (Figure 1).
Gross picture showing enlarged left testis.
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On gross examination, the testicle was enlarged (Figure 2), measuring 7 x 5.4 x 5 cm, and the spermatic cord was 6.7 x 2.6 cm.
Cut surface of the testicular mass showing areas of necrosis, calcification, and cystic area.
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Cut surface (Figure 3) showed a well-circumscribed variegated mass, measuring 7.0 x 5.2 x 4.8 cm.
Low power (a) and high power (b) views showing malignant spindle cells with abundant mitoses.
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Microscopic examination of the mass revealed predominantly overt malignant spindled cells displaying pleomorphism, hyperchromasia, and increased mitosis, with extensive necrosis in the background (Figure 4).
Areas of tumor showing rhabdomyoblastic differentiation.
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There were cells with abundant eosinophilic cytoplasm, some of which with striations, indicating rhabdomyoblastic differentiation (Figure 5).
Teratomatous components: glandular epithelium (a), ciliated columnar epithelium (b), cartilage (c), and epidermoid cyst (d).
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Scrutinous searching further identified different benign tissues including cartilage, squamous epithelium, and rare bone, respiratory and glandular epithelium (Figure 6).
Tumor showing positive desmin (a) and vimentin (b).
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Immunohistochemistry revealed that the tumor cells were positive for desmin and vimentin (Figure 7).
Myo-D positive in rhabdoid cells.
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The rhabdoid cells were positive for myogenin and focally weakly positive for MyoD (Figure 8).