Giant neurilemoma: unusual scrotal mass

A case of intrascrotal extratesticular schwannoma

Schwannomas are benign tumors arising from Schwann cells, which compose the myelin sheath covering peripheral nerves. Although schwannomas can develop in various locations throughout the human body, the scrotum is a rare site for development of a schwannoma. Furthermore, to the best of our knowledge, no study to date has focused on the detailed imaging findings of intrascrotal schwannoma.

Scrotal extratesticular schwannoma: a case report and review of the literature

BACKGROUND

Schwannomas are tumours arising from Schwann cells, which sheath the peripheral nerves. Here, we report a rare case of left intrascrotal, extratesticular schwannoma. Although rare, scrotal localisation of schwannomas has been reported in male children, adult men, and elderly men. They are usually asymptomatic and are characterised by slow growth. Patients generally present with an intrascrotal mass that is not associated with pain or other clinical signs, and such cases are self-reported by most patients. Imaging modalities (such as ultrasonography, computed tomography, and magnetic resonance imaging) can be used to determine tumour size, exact localisation, and extension. However, the imaging findings of schwannoma are non-specific. Therefore, only complete surgical excision can result in diagnosis, based on histological and immunohistochemical analyses. If the tumour is not entirely removed, recurrences may develop, and, although malignant change is rare, this may occur, especially in patients with a long history of an untreated lesion. Thus, follow up examinations with clinical and imaging studies are recommended for scrotal schwannomas.

CASE PRESENTATION

A 52-year-old man presented with a 3-year history of asymptomatic scrotal swelling. Physical examination revealed a palpable, painless, soft mass in the left hemiscrotum. After surgical removal of the mass, its histological features indicated schwannoma.

CONCLUSIONS

Schwannoma should be considered in cases of masses that are intrascrotal but extratesticular. Ultrasonography provides the best method of confirming the paratesticular localisation of the tumour, before surgical removal allows histopathological investigation and definitive diagnosis. Surgery is the standard therapeutic approach. To prevent recurrence, particular care should be taken to ensure complete excision. This case report includes a review of the literature on scrotal schwannomas.

Intrascrotal and extratesticular multiple schwannoma

Schwannoma, which may occur in any region of the body, is very rare in the scrotum. Schwannomas are tumors that originate from Schwann cells and, theoretically, could affect any nerve. In spite of the rich innervation of the genital area, these kinds of tumors are not common in the scrotum. A 67-year-old man visited our hospital for investigation of a 2-year episode of multiple slowly growing masses in the scrotum. Testicular tumor markers were within normal range (beta human chorionic gonadotropin <5 mIU, α-fetoprotein : 4.86 ng/ml). Scrotal ultrasonography revealed intrascrotal and extratesticular masses in the mid-scrotal region. Complete excision of the scrotal masses was performed. After surgery there was no testicular invasion. Histological examination of the resected specimen showed them to be schwannomas of the scrotum. We report one case of multiple schwannomas of the scrotum with a review of the literature.

A rare case of multiple schwannomas presenting with scrotal mass: a probable case of schwannomatosis

We report a rare case of multiple schwannomas presenting with scrotal mass. In the present case, a scrotal schwannoma developed in a 66-year-old man with a history of brain tumor surgery. Investigating the patient's past history lead to the diagnosis as probable schwannomatosis. Patients with schwannomatosis are at increased risk of developing multiple schwannomas and these patients need regular surveillance. In this regard, the present case highlights the importance of thorough history taking in patients with scrotal schwannoma.

Benign intratesticular schwannoma: a rare finding

Schwannoma is a peripheral nerve tumour, occasionally located in the genitourinary tract. We described an extremely rare case of intratesticular neurinoma in a 79-year-old patient.