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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2014, Vol. 8 Issue (4) : 484-488     DOI: 10.1007/s11684-014-0325-3
CASE REPORT |
Paratesticular fibrous pseudotumor: a report of five cases and literature review
Zhicheng Zhang,Jun Yang,Mingchao Li,Wei Cai,Qingquan Liu,Tao Wang,Xiaolin Guo,Shaogang Wang,Jihong Liu(),Zhangqun Ye
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Abstract  

Paratesticular fibrous pseudotumor is a rare benign tumor that originates from intrascrotal tissue, such as tunica vaginalis, epididymis, or spermatic cord. Five cases of fibrous pseudotumor in our hospital were reviewed retrospectively, and the clinical manifestations were analyzed. Three cases of unilateral nodules, comprising one case located in the tunica vaginalis and two cases located in the epididymis, underwent local excision of the unilateral nodule. Two cases of diffuse incrassation in the tunica vaginalis underwent right radical orchiectomy. Postoperative pathological examination showed that all were fibrous pseudotumors. An average follow-up of 26 months showed uneventful results without recurrence for all patients. Fibrous pseudotumor is not a neoplasm but a reactive fibrous inflammatory hyperplasia. Definitive diagnosis requires pathological examination. Radical orchiectomy should be avoided when possible, and local excision should be performed because of the lack of obvious evidence of potential malignancy.

Keywords fibroma      inflammation      scrotum      testicular neoplasm     
Corresponding Authors: Jihong Liu   
Just Accepted Date: 01 May 2014   Online First Date: 13 March 2014    Issue Date: 18 December 2014
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0325-3     OR     http://academic.hep.com.cn/fmd/EN/Y2014/V8/I4/484
Patient Age (year) Duration (year) Ultrasound Surgery Follow-up (month)
1 34 10 One nodule (1.2 cm × 0.5 cm) on the cauda of the right epididymis Local excision 40
2 38 1 One nodule (1.5 cm × 1.3 cm) on the caput of the left epididymis Local excision 27
3 26 2 Multiple nodules (maximum,1.0 cm × 1.1 cm)on the left tunica vaginalis Local excision 14
4 21 2 Diffuse incrassation of tunica vaginalis, testicular atrophy, and hydrocele (4.0 cm × 9.0 cm) with multiplecalcification Radical orchiectomy 3
5 60 3 Diffuse incrassation of tunica vaginalis, testicular atrophy, and hydrocele (4.2 cm × 6.1 cm) Radical orchiectomy 45
Tab.1  Clinical information of five men with fibrous pseudotumor
Fig.1  Scrotal Doppler ultrasound showed incrassated tunica vaginalis with low-resistance arterial signal, a large amount of hydrocele, and testicular atrophy.
Fig.2  Tunica vaginalis (triangle) demonstrated incrassation with a large amount of hydrocele and atrophy of the right testis (star).
Fig.3  (A) Widely hyalinized collagenous lesion with in?ltration of lymphocytes (H&E stain, × 400); (B) Vimentin (+) (original magni?cation, × 400); (C) Pancytokeratin (focal+ ) (original magni?cation, × 400); (D) EMA (focal+ ) (original magni?cation, × 400).
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