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Marrak M, Bibi M, Rahoui M, Ouanes Y, Chaker K, Nouira Y. Fibrous pseudo tumor of the tunica vaginalis mimicking paratesticular cancer. Urol Case Rep 2023; 51:102581. [PMID: 37928514 PMCID: PMC10622608 DOI: 10.1016/j.eucr.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
Fibrous pseudo tumor of the tunica vaginalis is a rare lesion affecting men representing a challenge in its diagnosis and treatment. We reported the case of a 17 year old male patient who presented for a right scrotal mass. Surgical resection of the mass was performed and the histological diagnosis was a fibrous pseudo tumor of the tunica vaginalis. It is usually affecting men in the third decade and the fear is to miss its main differential diagnosis which is testicular cancer. Studies should give more concern to this entity, so that we can avoid unnecessary orchiectomy.
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Affiliation(s)
- Mahdi Marrak
- Urology Department, LA RABTA Hospital of Tunis, Tunisia
| | - Mokhtar Bibi
- Urology Department, LA RABTA Hospital of Tunis, Tunisia
| | - Moez Rahoui
- Urology Department, LA RABTA Hospital of Tunis, Tunisia
| | | | - Kais Chaker
- Urology Department, LA RABTA Hospital of Tunis, Tunisia
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2
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Al-Shalah MI, Alabdallat S, Alzayed A, Abunaser N, Khamees A. Benign Paratesticular Fibrous Pseudotumor in a Young Male: A Case Report. Urology 2023; 176:171-174. [PMID: 36764489 DOI: 10.1016/j.urology.2023.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
Paratesticular fibrous pseudotumor (PFPs) is an uncommon intra-scrotal mass that originated from tunica vaginalis and resulted in a reactive fibrous proliferation after a history of inflammation, infection, trauma, or hydrocele. We report here on a case of a 17-year-old man with a mass in the hemiscrotum that was found to be PFP in the orchidectomy specimen pathologic examination. The diagnosis of PFPs, before and during the operation, can be complicated despite it being a benign tumor. Radical orchidectomy is usually performed for these types of lesions. A frozen section intraoperatively is essential to avoid unnecessary radical orchidectomy and preserve testicle.
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Affiliation(s)
- Mustafa I Al-Shalah
- Division of Urology, Department of Special Surgery, Al Bashir Hospital, Ministry of Health, Amman, Jordan
| | - Sadam Alabdallat
- Division of Urology, Department of Special Surgery, Al Bashir Hospital, Ministry of Health, Amman, Jordan
| | - Ashraf Alzayed
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - Neebal Abunaser
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
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3
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Paratesticular inflammatory pseudotumour, a rare case. Urol Case Rep 2022; 45:102211. [PMID: 36105543 PMCID: PMC9465314 DOI: 10.1016/j.eucr.2022.102211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/20/2022] Open
Abstract
Paratesticular masses are not infrequent, however the diagnosis is challenging. Differentiation from testicular tumours is of utmost importance. One of the rare forms is a fibrous pseudotumours with only about a couple of hundred cases documented worldwide. We present a case of left paratesticular inflammatory pseudotumour.
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4
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Pereira MWAP, Barbosa JABA, de Arruda Ribeiro CT, Shiang C, Yorioka MAW, Borges LL. Calcifying fibrous tumor: A rare spermatic cord presentation. Urol Case Rep 2020; 33:101418. [PMID: 33102115 PMCID: PMC7574282 DOI: 10.1016/j.eucr.2020.101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 11/06/2022] Open
Abstract
Calcifying fibrous tumor of the tunica vaginalis is a rare fibrous proliferation, which can sometimes mimic a scrotal malignancy prompting surgical intervention. It has been recognized as a benign lesion, and no recurrence has been described after its resection. Its identification is essential to avoid overtreatment and unnecessary orchiectomy. We herein describe a rare case of calcifying fibrous tumor of the tunica vaginalis in a young patient and review the clinical features of inguinal and scrotal calcifying fibrous tumors to help clinical decisions and encourage a testis sparing surgery.
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Abstract
BACKGROUND Paratesticular fibrous pseudotumor (PFP) is a rare benign tumor that can mimic malignant tumors; thus, radical orchiectomy was the standard treatment in the past. OBSERVATION A 15-year-old boy came to our attention for a hard right inguinal swelling. An ultrasound showed a highly vascularized mass. The boy underwent a gonadal-sparing excision of the mass that was diagnosed to be a PFP. The patient recovered well, without recurrences at the follow-up. CONCLUSIONS PFP is mostly asymptomatic, and its diagnosis is incidental. Only further 4 pediatric cases were reported in the literature. Our case confirms that gonadal-sparing surgery is an optimal treatment.
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Fibrous Pseudotumor of Tunica Albuginea Testis Mimicking Testicular Neoplasm in a Young Man. Case Rep Surg 2018; 2018:9315864. [PMID: 30026998 PMCID: PMC6031155 DOI: 10.1155/2018/9315864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/17/2018] [Indexed: 12/30/2022] Open
Abstract
Intrascrotal lesions are common findings with a majority occurring in paratesticular tissue. Fibrous pseudotumors are rare, benign lesions of the testicular tunics and present with mass lesion(s) in the scrotum. Preoperative clinical and radiological diagnosis is challenging. We report a case of a 34-year-old man who presented with a 3-year history of left testicular swelling and was advised left radical orchidectomy by another surgeon. Physical examination revealed a firm, nontender mass attached to the lower pole of the testis. Testicular tumor markers were all negative, and ultrasound scan showed a relatively hypoechoic lesion closely associated with the left testis and suspicious for neoplastic process. The patient underwent a testicular sparing surgery. An intraoperative frozen section biopsy confirmed the lesion to be benign and this was reported on permanent section to be fibrous pseudotumor of the tunica albuginea. We also present the clinical, sonographic, and histopathological findings of this condition along with the literature review.
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7
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A Case of Fibrous Pseudotumor in the Scrotum: Challenge for Diagnosis and Testicular Preservation. Case Rep Urol 2018; 2018:6904827. [PMID: 29593931 PMCID: PMC5822820 DOI: 10.1155/2018/6904827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 12/11/2017] [Accepted: 12/20/2017] [Indexed: 12/13/2022] Open
Abstract
A paratesticular fibrous pseudotumor is a relatively rare benign disease. Preoperatively diagnosing a fibrous pseudotumor is challenging because distinguishing these masses from malignant tumors on the basis of clinical and radiological findings can be difficult. We present a case of a 28-year-old man who presented with a painless palpable mass in the right scrotum; the fibrous pseudotumor of the tunica vaginalis was treated with organ-sparing surgery. Computed tomography and magnetic resonance imaging revealed paratesticular tumors. Testicular tumor marker levels were within normal limits. We scheduled the patient to undergo tumor biopsy combined with intraoperative rapid diagnosis. Frozen section assessment suggested a fibrous pseudotumor without malignancy. We successfully performed organ-sparing surgery. Testicular-sparing surgery combined with frozen section assessment is primarily used for treating paratesticular fibrous pseudotumors.
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Nistal M, Paniagua R, González-Peramato P, Reyes-Múgica M. Perspective in Pediatric Pathology, Chapter 24. Testicular Inflammatory Processes in Pediatric Patients. Pediatr Dev Pathol 2017; 19:460-470. [PMID: 27575254 DOI: 10.2350/16-08-1828-pb.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Acute scrotal pain in children represents a major diagnostic and therapeutic challenge. An important initial differentiation should be made between epididymitis and other processes that cause acute scrotal pain, such as testicular torsion and tumor. Infectious agents disseminating through the blood flow can damage the testis by causing orchitis. On the other hand, infections ascending via spermatic pathways typically lead to epididymitis [ 1 ].
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Affiliation(s)
- Manuel Nistal
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Madrid 28029, Spain
| | - Ricardo Paniagua
- 2 Department of Cell Biology, Universidad de Alcala, Madrid, Spain
| | - Pilar González-Peramato
- 1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Madrid 28029, Spain
| | - Miguel Reyes-Múgica
- 3 Department of Pathology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
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9
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Kang W, Cui Z, Li X, Sun P, Jin X. Calcifying Fibrous Tumor of the Tunica Vaginalis Testis: A Report of 2 Cases. Urology 2017; 100:e9-e13. [DOI: 10.1016/j.urology.2016.09.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/08/2016] [Accepted: 09/14/2016] [Indexed: 11/29/2022]
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Turkan S, Kalkan M, Ekmekcioglu O, Haltas H, Sahin C. Paratesticular Fibrous Pseudotumors. Rare Tumors 2016; 8:6288. [PMID: 27441080 PMCID: PMC4935829 DOI: 10.4081/rt.2016.6288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/09/2016] [Accepted: 01/10/2016] [Indexed: 11/23/2022] Open
Abstract
Paratesticular fibrous pseudotumors (PFPs) are rare pathologies with quite wide and variable topographic-morphological features. It is difficult to distinguish PFPs from malignant masses. Treatment can be done by resection of the mass. We reported a young patient’s findings about this rare pathology.
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Affiliation(s)
- Sadi Turkan
- Department of Urology, Private Kastamonu Anadolu Hospital , Kastamonu
| | - Mehmet Kalkan
- Department of Urology, Fatih University Faculty of Medicine , Istanbul, Turkey
| | - Ozan Ekmekcioglu
- Department of Urology, Private Kastamonu Anadolu Hospital , Kastamonu
| | - Hacer Haltas
- Department of Pathology, Fatih University Faculty of Medicine , Istanbul, Turkey
| | - Coskun Sahin
- Department of Urology, Fatih University Faculty of Medicine , Istanbul, Turkey
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Akan S, Yuksel OH, Ozbay N, Verit A. Testicular fibrous pseudotumour as a rare intrascrotal mass. Rev Int Androl 2015. [DOI: 10.1016/j.androl.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Başal Ş, Malkoç E, Aydur E, Yıldırım İ, Kibar Y, Kurt B, Göktaş S. Fibrous pseudotumors of the testis: The balance between sparing the testis and preoperative diagnostic difficulty. Turk J Urol 2015; 40:125-9. [PMID: 26328164 DOI: 10.5152/tud.2014.21284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/26/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine a paradigm that will be helpful for urologists to manage fibrous pseudotumors, which are a very rare condition of the testis. MATERIAL AND METHODS We retrospectively evaluated the patients with fibrous pseudotumors in our uropathological database from 1995 to 2013. Patients who had tumor markers and ultrosonography (USG) screening before surgery and a final pathology report of a fibrous pseudotumor were included in the study. RESULTS In total, 838 patients with a testis mass were evaluated. Only 6 of these patients met the inclusion criteria. The mean age was 34 years (min: 20, max: 72). Serum tumor markers were in the normal range for all patients. The scrotal tumors were not clearly related to the testis parenchyma, and the radiologists could not definitively determine the nature of the masses (benign or malignant). A concomitant hydrocele was detected in 2 patients. After inguinal exploration, radical orchiectomy was performed in one patient with an ipsilateral atrophic testis, and biopsies were taken from the lesions for frozen section analysis in the other 5 patients. Pathologists reported benign tumors for all of these patients based on the frozen sections, and testicular sparing surgery was then performed in these 5 patients. CONCLUSION If scrotal tumors are detected by ultrasonography in patients with normal tumor markers, and the tumor cannot be clear distinguished from the testis, these patients might have a fibrous pseudotumor, and organ-sparing surgery can be performed on these patients.
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Affiliation(s)
- Şeref Başal
- Department of Urology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey
| | - Ercan Malkoç
- Department of Urology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey
| | - Emin Aydur
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
| | - İbrahim Yıldırım
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Yusuf Kibar
- Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Bülent Kurt
- Department of Pathology, Gülhane Military Medical Academy, Ankara, Turkey
| | - Serdar Göktaş
- Department of Urology, Selçuklu University Faculty of Medicine, Konya, Turkey
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Tirtayasa PMW, Birowo P, Putranto AS, Rasyid N. Fibrous Pseudotumor of the Tunica Vaginalis Associated With Hydrocele and Testicular Atrophy. Urol Case Rep 2014; 2:134-6. [PMID: 26839791 PMCID: PMC4735483 DOI: 10.1016/j.eucr.2014.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 05/06/2014] [Indexed: 11/25/2022] Open
Abstract
Fibrous pseudotumors of the testicular tunics and paratesticular tissue are uncommon lesions. They typically arise as painless scrotal masses that may be associated with hydrocele or history of surgery, trauma, or infection. Although benign, these lesions often clinically indicate malignancy and usually remain undiagnosed preoperatively. Here, we report on a 59-year-old man with fibrous pseudotumor of the tunica vaginalis associated with hydrocele and testicular atrophy.
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Affiliation(s)
- Pande Made Wisnu Tirtayasa
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ponco Birowo
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Nur Rasyid
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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14
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Paratesticular fibrous pseudotumor: a report of five cases and literature review. Front Med 2014; 8:484-8. [PMID: 24627288 DOI: 10.1007/s11684-014-0325-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
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.
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15
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Zengin K, Sener NC, Alisir I. Magnetic resonance imaging of paratesticular inflammatory pseudotumor: a case report. Clin Genitourin Cancer 2012; 11:204-6. [PMID: 22995225 DOI: 10.1016/j.clgc.2012.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/18/2012] [Accepted: 08/16/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Kursad Zengin
- Diskapi Yildirim, Beyazid Teaching and Research Hospital, Urology Clinic, Ankara, Turkey
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16
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Gordetsky J, Findeis-Hosey J, Erturk E, Messing EM, Yao JL, Miyamoto H. Role of frozen section analysis of testicular/paratesticular fibrous pseudotumours: a five-case experience. Can Urol Assoc J 2011; 5:E47-51. [PMID: 21806893 DOI: 10.5489/cuaj.10144] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fibrous pseudotumours of the testicular and paratesticular tissues are fibroinflammatory reactive lesions that can clinically mimic neoplasms. Very little is known about the role of frozen section analysis (FSA) for these lesions in terms of intraoperative surgical management. METHODS We recently experienced 5 patients with testicular/paratesticular fibrous pseudotumours in whom frozen sections were used to demonstrate its non-neoplastic nature prior to the decision for radical surgery. RESULTS In 2 cases, FSA resulted in testicular-sparing surgery. In contrast, the remaining 3 cases ultimately underwent radical orchiectomy, due to questionable viability of the testicle involved by inflammatory/infiltrative lesions and in 1 case a slight possibility of lymphoproliferative malignancy. CONCLUSION Urologists should be aware of this entity and its gross features, such as firm masses and diffuse fibrous proliferation encasing the testicle to help determine intraoperative management. In select cases, intraoperative FSA is helpful in obviating radical orchiectomy.
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Affiliation(s)
- Jennifer Gordetsky
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY; Department of Urology, University of Rochester Medical Center, Rochester, New York, USA
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17
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Pseudotumeur inflammatoire du cordon spermatique sur testicule ectopique: à propos d’un cas. Basic Clin Androl 2010. [DOI: 10.1007/s12610-010-0104-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Résumé
Les auteurs rapportent le premier cas de pseudotumeur du cordon spermatique observé chez un sujet présentant une ectopie testiculaire. L’exploration chirurgicale avait permis de retrouver une masse funiculaire surplombant le testicule, masse dont l’analyse histologique était revenue en faveur d’une funiculite pseudotumorale. À travers l’analyse de ce cas et une revue de la littérature, nous allons discuter des aspects diagnostiques et thérapeutiques de ces tumeurs paratesticulaires rares.
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18
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Garriga V, Serrano A, Marin A, Medrano S, Roson N, Pruna X. US of the tunica vaginalis testis: anatomic relationships and pathologic conditions. Radiographics 2010; 29:2017-32. [PMID: 19926760 DOI: 10.1148/rg.297095040] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Extratesticular lesions are common incidental findings at ultrasonography (US) among men and boys. Most lesions originate from or depend on the tunica vaginalis, a mesothelium-lined sac with a visceral layer and a parietal layer. The tunica vaginalis is formed when the superior portion of the processus vaginalis closes during embryologic development. Abnormal closure of the processus vaginalis leads to congenital anomalies of the tunica vaginalis, such as complete or partial patency of the processus vaginalis, spermatic cord hydrocele, and inguinoscrotal hernia. The proximity of the visceral layer to the testis explains the reactive involvement seen in epididymo-orchitis, with resultant pyocele or abscess formation. The tunica vaginalis also may be affected by inflammatory and traumatic disorders such as scrotal calculi, fibrous pseudotumor, or hematocele. These lesions manifest as solid or heterogeneous tumorlike masses. Lesions of mesothelial origin, such as adenomatoid tumor, tunica cyst, and mesothelioma, may involve the tunica vaginalis. Entrapped mesenchymal cells can lead to lipoma, leiomyoma, or sarcoma, although these tumors are uncommon in the tunica vaginalis. US is not useful for differentiating between benign and malignant tumors; however, some characteristic findings may help in planning the best surgical approach. Knowledge of the embryologic development, anatomic relationships, and pathologic disorders of the tunica vaginalis is essential to narrow the differential diagnosis of an extratesticular lesion. In most cases, US findings in combination with clinical assessment can indicate whether nonsurgical management or testis-sparing surgery is warranted.
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Affiliation(s)
- Victoria Garriga
- Department of Radiology, Hospital General de Granollers, Fundació Hospital-Asil de Granollers, Granollers, Spain.
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Paratesticular Fibrous Pseudotumor: A Morphologic and Immunohistochemical Study of 13 Cases. Am J Surg Pathol 2010; 34:569-74. [DOI: 10.1097/pas.0b013e3181d438cb] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Rakoto-Ratsimba HN, Randriambololona VH, Rakototiana AF, Ranaivozanany A. [Iatrogenic paratesticular fibrous pseudotumor]. Prog Urol 2009; 19:353-5. [PMID: 19393543 DOI: 10.1016/j.purol.2008.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Accepted: 10/29/2008] [Indexed: 10/21/2022]
Abstract
Authors report a case of probably iatrogenic paratesticular fibrous pseudotumor. A 33-year-old man presented with a history of increased scrotal volume after laborious urethral catheterism. Ultrasound scanning first suggested testicular malignant lesion. Surgical findings showed thick and fibrous scrotal wall surrounding a pseudocystic cavity which contained urine coming from a bulbar urethral rupture. Testicles were normal. Urethral suture and total excision of the scrotal mass were performed. Diagnosis was histologically corrected. Diagnosis and management are discussed with a review of the literature.
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Affiliation(s)
- H N Rakoto-Ratsimba
- Service de chirurgie viscérale, CHU HJRA-Ampefiloha, BP 4150, 101 Antananarivo, Madagascar.
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21
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Nistal M, Gonzalez-Peramato P, Serrano A, Reyes-Mugica M, Cajaiba MM. Primary intratesticular spindle cell tumors: interdigitating dendritic cell tumor and inflammatory myofibroblastic tumor. Int J Surg Pathol 2008; 19:104-9. [PMID: 18805870 DOI: 10.1177/1066896908323505] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Spindle cell neoplasms arising in the testis are uncommon; most cases belong to the category of gonadal stromal tumors, and the presence of distinctive clinical and pathological features usually lead to a definitive diagnosis. In some instances, however, the diagnosis of these tumors can be challenging and special techniques are needed. The present study reports 2 unusual cases of primary intratesticular tumors showing a striking morphology, characterized by spindle to stellate cells in a lymphoid background. The diagnosis of interdigitating dendritic cell tumor and inflammatory myofibroblastic tumor was established in the 2 cases, and their probable origin in cells of the accessory immune system is discussed. Although both tumors share similar histological features, their immunohistochemical profiles were decisive for a definitive diagnosis.
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Affiliation(s)
- Manuel Nistal
- Department of Pathology, Hospital La Paz, Madrid, Spain
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22
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Abstract
Fibrous benign proliferations of the testis and paratesticular tissues are an uncommon and heterogeneous group of lesions that can mimic true neoplasms. Among them, those considered to be reactive proliferations have been included in the category of fibrous pseudotumors and are often associated with trauma, hydrocele, or infection. We report 2 cases of nodular and diffuse fibrous proliferation. This condition is part of the spectrum of reactive benign fibrous lesions and has previously been described in the testicular tunics and paratesticular region only. One of our 2 cases had the peculiarity of being located in the penile shaft, whereas the other involved the tunica vaginalis. To the best of our knowledge, this is the first report of a diffuse and nodular fibrous tumor involving the penis.
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Affiliation(s)
- Akshay Bhandari
- Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan, USA
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24
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Pedro Borges R, Simeão Versos R, Vila F, Cavadas V, Encinas A, Oliveira A, Marcelo F. Pseudotumor escrotal inflamatório. Rev Int Androl 2007. [DOI: 10.1016/s1698-031x(07)74091-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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25
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Germaine P, Simerman LP. Fibrous pseudotumor of the scrotum. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:133-8. [PMID: 17182720 DOI: 10.7863/jum.2007.26.1.133] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Pauline Germaine
- Department of Radiology, Pennsylvania Hospital, Philadelphia, PA 19107, USA
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Parker PM, Pugliese JM, Allen RC. Benign fibrous pseudotumor of tunica vaginalis testis. Urology 2006; 68:427.e17-9. [PMID: 16904471 DOI: 10.1016/j.urology.2006.02.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Revised: 01/12/2006] [Accepted: 02/20/2006] [Indexed: 10/24/2022]
Abstract
We discuss the rare benign paratesticular mass identified as fibrous pseudotumor. We performed a published data search to review the etiology, incidence, gross and microscopic examinations, and pathologic diagnostic considerations. Fibrous pseudotumor is a rare, benign lesion. Histologic examinations, as well as concerted efforts between the pathologist and surgeon, are necessary for appropriate diagnosis and treatment.
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Affiliation(s)
- Patrick M Parker
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
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White WM, Hilsenbeck J, Waters WB. Fibromatous periorchitis of testis. Urology 2006; 67:623.e15-6. [PMID: 16527591 DOI: 10.1016/j.urology.2005.09.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Revised: 09/07/2005] [Accepted: 09/29/2005] [Indexed: 11/22/2022]
Abstract
Fibrous pseudotumors of the tunica vaginalis, epididymis, and spermatic cord are uncommon benign paratesticular masses. An extremely rare variant termed "fibromatous periorchitis" exhibits diffuse proliferative encasement of the testis and manifests grossly as an indurated testis reminiscent of malignancy. We present the case of a 25-year-old man who presented with a grossly abnormal testicular examination and benign scrotal ultrasound findings and pathologic evidence of fibromatous periorchitis. The natural history, gross and histologic findings, and management of fibrous pseudotumors and fibromatous periorchitis are discussed.
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Affiliation(s)
- Wesley M White
- Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee 37920, USA.
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