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Clinically this lesion is usually asymptomatic. The ultrasound appearance of a microcystic or multiple tubular-like lesions located at the mediastinal testis [Fig. 23] and associated with an epididymal cyst in a middle-aged or elderly patient should alert the sonographer to the possibility of tubular ectasia.
The mediastinum testis is a thick yet incomplete septum at the posterior part of the testis formed by the tunica albuginea of testis projecting into the testis at its posterior aspect where the testis is not lined by the serous membrane to allow for the attachment of the epididymis.
Ultrasound image showing tubular ectasia of the rete testis as an incidental finding in an 81 year old male. Rete tubular ectasia, also known as cystic transformation of rete testis [1] is a benign condition, usually found in older men, involving numerous small, tubular cystic structures within the rete testis.
The connective tissue of the tunica albuginea testis extends into the substance of the testis to form fibrous partitions - the septa testis. [1] At the posterior aspect of the testis (where the serosa of testis is deficient to allow for the attachment of the epididymis), the tunica albuginea extends into the testis to form the mediastinum ...
The rete testis (/ ˈ r iː t i ˈ t ɛ s t ɪ s / REE-tee TES-tis; pl.: retia testes) is an anastomosing network of delicate tubules located in the hilum of the testicle (mediastinum testis) that carries sperm from the seminiferous tubules to the efferent ducts. It is the homologue of the rete ovarii in females. [1]
The tubuli seminiferi recti (also known as the tubuli recti, tubulus rectus, or straight seminiferous tubules) are structures in the testicle connecting the convoluted region of the seminiferous tubules to the rete testis, although the tubuli recti have a different appearance distinguishing them from these two structures.
The septa testis are fibrous partitions of the testis dividing the testis into compartments - the lobules of the testis. The septa are formed by extensions of the tunica albuginea - the dense fibrous connective tissue surface covering of the testis - into the substance of the testis. The septa converge towards the mediastinum testis. [1]
The treatment for mediastinal nonseminomatous germ cell tumors should follow guidelines for poor-prognosis testicular cancer. Initial treatment with four courses of bleomycin, etoposide, and cisplatin, followed by surgical resection of any residual disease, is considered standard therapy.