Leiomyoadenomatoid tumors: A type of rare benign epididymal tumor

Epididymal adenomatoid tumor: a case report and literature review

Background

Adenomatoid tumor is a very rare benign neoplasm of mesothelial origin affecting mainly female and male genital tracts. The diagnosis is challenging as this tumor mimics many differential diagnoses. The current literature offers only some case reports and short series of adenomatoid tumors.

Case presentation

A 47-year-old patient with unremarkable medical history presented for chronic mild pain of the right testis evolving for months. The physical examination shows a palpable right intrascrotal nodule of 10 mm in greatest diameter. The nodule was painful, mobile with firm consistency. The laboratory investigations were within normal limits, the scrotal ultrasonography showed a well-circumscribed predominantly hyperechoic intrascrotal nodule in the right epididymal head with heterogeneous echostructure. Excisional biopsy of the lesion was performed and the histopathological analysis showed a well-circumscribed tumor with microcystic and trabecular architecture made of small interconnected tubules and cysts lined by flattened cells with prominent vacuolization and thread-like bridging strands, consistent with an epididymal adenomatoid tumor. The postoperative course was uneventful and the patient was discharged. Four months after surgical treatment, the patient has no sign of the disease.

Conclusion

Testicular adenomatoid tumors are uncommon benign neoplasms with diagnostic challenge. Adenomatoid tumors arising in epididymis are managed by excisional biopsy with testis-sparing surgery avoiding unnecessary orchidectomy.

Leiomyoadenomatoid tumours of the epididymis: A new case report and review of the literature

Benign tumours of the epididymis are rare, and the most common tumour types include adenomatoid tumours, representing more than half of all cases, and leiomyomas. Here, we reported a case of leiomyoadenomatoid tumours of the epididymis, a very rare, benign histological entity with only few cases described in the English literature, which have been reviewed and summarised. Clinically, the lesion presented as a solitary mass growing at the level of the tail of the right epididymis. After the intraoperative frozen section analysis revealed a benign adenomatoid lesion, the mass was enucleated with a conservative surgery sparing the testis. This case highlights the importance for both pathologists and urologists to be aware of these rare, but benign, tumours, to avoid misdiagnosis, especially in the setting of frozen intraoperative consultation, or primary radical surgical procedures, as radical orchiepididymectomy without frozen section consultation.