Ultrasound Examination of Unilateral Seminoma in a Salernitano Stallion

SIMPLE SUMMARY: An 18-year-old Salernitano stallion was presented for enlargement of the left testicle with no other clinical signs. Sonoelastographic examination showed parenchymal changes with deformation of the normal testis, appearing with an irregular profile. Unilateral orchiectomy was performed. Considering gross, microscopic and immunohistochemical findings, a definitive diagnosis of diffuse seminoma was made. Three months later, follow-up assessment showed no evidence of recurrence, preserved reproductive abilities or fertility, but did show reduced testosterone levels. ABSTRACT: An 18-year-old Salernitano stallion developed a progressive enlargement of the left testicle over eight months. An ultrasound evaluation was performed, along with a hormonal profile. A histopathological evaluation of the testis was performed after unilateral orchiectomy. On B-mode ultrasound examination, testicular parenchyma was characterized by the loss of internal structure, with the presence of multiple coalescing, nodular, well-defined and heterogeneous lesions with capsule deformity, appearing with an irregular profile. On dissection, the testicular parenchyma bulged over the cut section, confirming the increase in size. Microscopically, the lesion consisted mainly of large, densely packed, polygonal-to-round-shaped neoplastic cells. Mitotic figures were plentiful and frequently atypical; further microscopic features included apoptosis and necrosis. At immunohistochemistry, the entire neoplasm showed strong and diffuse immunolabeling for vimentin, while CD117-specific immunoreactivity was only observed in scattered clusters of neoplastic cells. Based on the gross, microscopic and IHC findings, a diagnosis of diffuse seminoma was made. Three months later, a follow-up examination showed no evidence of recurrence and the preservation of reproductive abilities. The case presented shows an unusual ultrasonographic pattern for seminoma and the basis of the correlation between the characteristics of the sonoelastographic examination and histological diagnosis.