Rete testis invasion is consistent with pathologic stage T1 in germ cell tumors

Ayesha Farooq, Merce Jorda, Elizabeth Whittington, Oleksandr N. Kryvenko, Beth L. Braunhut, Nicola Pavan, Kristýna Procházková, Lian Zhang, Samarpit Rai, Tegan Miller, Joy Liu, Aniko Szabo, Kenneth A. Iczkowski

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives Rete testis invasion by germ cell tumors is frequently concomitant with lymphovascular or spermatic cord invasion (LVI/SCI); independent implications for staging are uncertain. Methods In total, 171 seminomas and 178 nonseminomatous germ cell tumors (NSGCTs; 46 had 1%-60% seminoma component) came from five institutions. Metastatic status at presentation, as a proxy for severity, was available for all; relapse data were unavailable for 152. Rete direct invasion (ReteD) and rete pagetoid spread (ReteP) were assessed. Results ReteP and ReteD were more frequent in seminoma than NSGCT. In seminoma, tumor size bifurcated at 3 cm or more or less than 3 cm predicted metastatic status. Tumors with ReteP or ReteD did not differ in size from those without invasions but were less than with LVI/SCI; metastatic status or relapse did not show differences. In NSGCT, ReteP/ReteD did not correlate with size, metastatic status, or relapse. Conclusions Findings support retaining American Joint Committee for Cancer pathologic T1 stage designation for rete testis invasion and pT1a/pT1b substaging of seminoma.

Original languageEnglish (US)
Pages (from-to)479-485
Number of pages7
JournalAmerican journal of clinical pathology
Issue number5
StatePublished - Apr 2 2019


  • Epididymis
  • Nonseminomatous germ cell tumor
  • Pathologic stage
  • Rete
  • Seminoma
  • Testis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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