A 35 year-old male presented with a right-sided, scrotal swelling of three days’ duration associated with acute scrotal pain of increasing severity. His past medical history was not significant and there was no history of trauma. Clinical examination revealed an enlarged, firm, tender nodule, three cm in diameter, while the contralateral testis was normal. A clinical diagnosis of torsion testis/testicular neoplasm was made. All routine investigations gave normal results. An emergency scrotal ultrasonography (USG) revealed a 2.5 cm, single, ovoid, well-defined, hypoechoic, solitary mass in the right testis. Guided aspiration was done under local anesthesia using a 10 mL syringe and a 24 gauge needle to obtain a scanty, grey-white aspirate. The smears were stained with hematoxylin-eosin (H and E), Papanicolaou, and May-Grünwald-Giemsa (MGG) stains. The smears were moderately cellular, consisting of tumor cells arranged in sheets and clusters. The cells were round to oval, having eccentric, vesicular nuclei with a fine granular chromatin along with a pale/vacuolated cytoplasm []. A cytological diagnosis of adenomatoid tumor was made. The patient underwent orchidectomy as the mass was firmly adherent to the tunica albugenia making conservative surgery unfeasible. The specimen showed the testis with a well circumscribed, encapsulated mass measuring 2.5 × 2 cm [] and its cut section was gray white. Histopathological examination (HPE) showed cuboidal to flat epithelial cells in solid cords, some lining the cystic spaces. Some of these epithelial cells showed prominent cytoplasmic vacuolation. Intervening stroma showed fibrocollagenous tissue with sparse lymphocytic infiltrates []. These features were consistent with those of an 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.