Benign fibrous paratesticular tumors

Nodular and diffuse fibrous proliferation of the penis and tunica vaginalis

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.

Fibrous pseudotumor of tunica vaginalis and epididymis

Paratesticular fibrous pseudotumors are rare, and less than 10% of them affect the epididymis. We report a case of testicular trauma that progressed to a painless palpable tumor in the right hemiscrotum with increased local volume. Orchiectomy followed by anatomic-pathologic examination revealed a paratesticular fibrous pseudotumor. The best treatment is scrotal exploration and frozen biopsy. On confirmation of the diagnosis, only the tumor and the tunica vaginalis are resected. Should the benign nature not be possible to determine, orchiectomy is the procedure of choice. We also reviewed published reports for this possibility in the differential diagnosis of testicular masses.

Benign fibromatous tumors of the testis and paratesticular region: a report of 9 cases with a proposed classification of fibromatous tumors and tumor-like lesions

Benign intrascrotal fibrous proliferations are uncommon, with most arising from the paratesticular region and falling into the category of so-called fibrous pseudotumor. We describe two neoplastic forms of benign fibrous tumor of the testis and its adnexa: fibroma of gonadal stromal origin and fibroma of the testicular tunics. Three patients with gonadal stromal fibroma were 28, 33, and 35 years of age and presented with painless masses. The tumors were circumscribed, intratesticular, yellow-white or white lesions 0.9 to 4.0 cm in diameter and had microscopic features identical to those of the ovarian fibroma. Immunohistochemically, the tumor cells were strongly positive for vimentin (3/3 cases), focally positive for actin and desmin (2/3 cases) and negative for S-100, keratin, and CD34 (3/3 cases). Six fibromas of the testicular tunics arose in patients 22, 34, 60, 68, 70, and 74 years old and were also asymptomatic masses. Four of them were circumscribed, whorled, white masses arising from the tunica albuginea with variable areas of myxoid change; one was pedunculated and grew exclusively into the cavity of the tunica vaginalis, whereas the other three at least partially extended into the testis as well. The other two tumors were unattached to the tunica albuginea and presented as circumscribed, white-tan paratesticular masses, partially covered by tunica vaginalis. Microscopically, the tumors were slightly to moderately cellular, with bland spindle or stellate cells lying in a myxoid or collagenous stroma with prominent vessels. The two paratesticular tumors had features typical of solitary fibrous tumor. Immunohistochemically, the fibromas of the testicular tunics were negative for S-100, keratin, and desmin. Focal, weak reactivity for actin was present in one case. CD34 was positive in three cases; in the two tumors resembling solitary fibrous tumors it was strong, and in the other it was focal and was limited to the region just below the tunica vaginalis. Eight tumors were treated by radical orchiectomy and one by excision of the mass alone. The outcome was benign in the seven cases in which followup information is available.

Benign fibrous testicular pseudotumors in children

Benign fibrous pseudotumors of the testicular tunics are rare in children. We report 2 cases of benign fibrous pseudotumors that were managed with gonad sparing surgery. We discuss the etiology, evaluation and treatment of benign fibrous pseudotumors of the testis.

Nodular fibrous proliferation (fibrous pseudotumour) of the tunica vaginalis testis. A light, electron microscopic and immunocytochemical study of a case and review of the literature

A case of nodular fibrous proliferation of the tunica vaginalis testis occurring in a 25-year-old male is described. Electron microscopy and immunocytochemical analysis confirm a fibroblastic origin. The histogenesis of the lesion is considered in the light of the findings and a review of the literature. It is concluded that the lesions known variously as 'fibrous pseudotumour' and 'reactive periorchitis' represent a fibroblastic overgrowth of the genito-urinary tract in response to trauma or infection. Nodular or diffuse fibrous proliferation of the testicular tunica vaginalis is suggested as a unifying terminology for this group of lesions.

Testicular adnexal fibrous pseudotumors

Fibrous pseudotumors of the testicular adnexae presenting clinically as a testicular malignancy are uncommon. Although fibrous pseudotumors are benign, they are usually diagnosed after radical orchiectomy. Radical orchiectomy occasionally may be avoided if this benign process is considered in the differential diagnosis of testicular neoplasms.