A 41 year old male presented to our department with left sided scrotal swelling and pain for fifteen days. There was no history of trauma or surgery. Local examination revealed a firm, tender nodule 2.5 cm in diameter. The contralateral testis was normal. Clinical diagnosis of testicular neoplasm/epididymal cyst was made. Investigations revealed normal serum α-fetal protein, human chorionic gonadotropin and lactate dehydrogenase levels. Scrotal ultrasonography revealed 2.5 cm well defined, heterogeneous, hypo echoic solitary mass in the left testis. Guided aspiration was done using 10 mL syringe and 24 gauge needle. Scanty, grayish white aspirate was obtained. Smears were stained with hematoxylin and eosin (H and E), Papanicolaou and May–Grόnwald-Giemsa (MGG) stains.\nModerately cellular smears consisted of tumor cells arranged in monolayered sheets and loosely cohesive clusters. Cells were round to oval with indistinct cell borders and moderate to abundant pale vacuolated cytoplasm. The monomorphic nuclei were eccentrically placed with fine granular chromatin and small inconspicuous nucleoli. Occasional binucleated cells were seen. Background showed pink amorphous material along with bare nuclei and few lymphocytes []. These cytological features suggested the diagnosis of AT. The patient underwent conservative testis sparing surgery, with excision of nodule.\nGrossly, an encapsulated grayish white mass measuring 2.5 × 2 × 1.8 cm was obtained. Microscopic examination revealed cuboidal to flat epithelial cells in solid cords, tubules and cystic spaces, some showing cytoplasmic vacuolation. Intervening stroma showed fibrocollagenous tissue with sparse lymphocytic infiltrate. Epithelial cells showed periodic acid schiff (PAS) positivity, the features consistent with adenomatoid tumor.
A 30 year-old male presented with a right-sided, tender scrotal swelling of four days’ duration. He had no significant past medical history or history of trauma. On local examination, a firm, mobile, and tender mass measuring 2 × 2 cm was found; the contralateral testis was normal. A clinical diagnosis of tuberculous epididymitis or testicular neoplasm was made. Routine hematological and biochemical investigations, urine analysis, and a chest radiograph revealed no abnormalities. USG of the scrotum showed a well defined, hypoechoic mass measuring 2.5 × 2 cm in the region of the globus major of the right epididymis. Aspiration was done using a 10 mL syringe and a 24 gauge needle to yield a scanty, grey-white aspirate. The smears were stained with H and E, Papanicolaou, and MGG stains. The cytological features were similar as those of case 1 and a diagnosis of an adenomatoid tumor was made. The patient underwent a conservative testis-sparing surgery with the excision of the epididymal nodule. The nodule measured 2 × 2 cm and the cut section was grey-white with microcysts. The results of the histopathological investigation were consistent with features of an AT.