Abstract
Tumors arising in the spermatic cord are very rare. The common benign tumors of the spermatic cord include adenomatoid tumor, lipoma, neurofibroma, and leiomyoma. We report a rare case of fibrous pseudotumor of the spermatic cord presenting clinically as a hydrocele. A 28-year-old male presented with the complaint of swelling in the left scrotum, which gradually progressed in size over four years. Clinically, the swelling was soft and fluctuant. The left testis was not separately made out and a diagnosis of left hydrocele was made. On scrotal exploration, a large 12 x 7 cm fleshy mass was seen in the left hemiscrotum with the left testis adherent to the upper pole of the mass. The mass was dissected out from the testis, and the histology showed features of fibrous pseudotumor of the spermatic cord. Fibrous pseudotumor of the spermatic cord is a very rare entity and can pose a diagnostic challenge. Preoperative scrotal ultrasound and intraoperative frozen section assessment can prevent unnecessary orchiectomies in young patients with paratesticular fibrous pseudotumors.
Highlights
Paratesticular fibrous pseudotumors are rare lesions involving the testicular tunics and the paratesticular soft tissues
We report a rare case of fibrous pseudotumor of the spermatic cord presenting clinically as a hydrocele
We describe a rare case of a diffuse fibrous pseudotumor that presented clinically as a soft, fluctuant scrotal swelling mimicking a hydrocele
Summary
Paratesticular fibrous pseudotumors are rare lesions involving the testicular tunics and the paratesticular soft tissues. The etiology is not known, though they are thought to be a reactive condition following trauma or infection They typically present as painless multinodular scrotal masses that are usually firm to hard in consistency. They may mimic a malignancy, but they are composed of dense fibrous tissue with interspersed bland fibroblasts and myofibroblasts and mixed inflammatory cells. We describe a rare case of a diffuse fibrous pseudotumor that presented clinically as a soft, fluctuant scrotal swelling mimicking a hydrocele. This case report highlights the importance of clinical examination and preoperative ultrasonography in patients presenting clinically with a hydrocele, especially in high volume government hospitals in developing countries. Based on the histology and immunohistochemistry features, the tumor was reported as a fibrous pseudotumor of the spermatic cord
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