Abstract
Paratesticular fibrous pseudotumor is a rare benign intrascrotal lesion. Although it may be difficult to preoperatively distinguish from malignancy, testis-sparing surgery is preferable if the tumor and testis can be dissected, especially in younger patients. We report a case of a paratesticular fibrous pseudotumor in which orchiectomy could be avoided. A man in his thirties presented with left scrotal swelling. An ultrasound examination revealed hypoechoic multinodular solid lesions attached to the thickened tunica vaginalis. Color Doppler showed mild vascularity in the nodules. Magnetic resonance imaging (MRI) revealed low signal intensity on T1-, T2-, and diffusion-weighted images with moderate contrast enhancement. Since the adhesion between the mass and the testis was not noticeable on surgical exploration, testis-sparing surgery was performed. Histopathologically, there was densely hyalinized fibrous tissue with scattered aggregates of inflammatory cells. The final histopathological diagnosis was a fibrous pseudotumor of the tunica vaginalis. Fibrous pseudotumor should be considered when a multinodular mass attached to the tunica vaginalis is hypoechoic on ultrasonography and shows low signal intensity on MRI T1-, T2-, and diffusion-weighted images. If the testis and the mass can be dissected intraoperatively, testicular sparing may be possible.
