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Liu H, Li P, Cui Y, Liu C. A case report and literature analysis of spermatic cord aggressive fibromatosis: A rare locally invasive tumor. Asian J Surg 2023; 46:4853-4854. [PMID: 37302883 DOI: 10.1016/j.asjsur.2023.05.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Hongquan Liu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Peng Li
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China.
| | - Chu Liu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China.
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2
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Hogan D, Pepdjonovic L, Dow C, Yao HH. Paratesticular fibromatosis: A rare cause of testicular mass. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415820961927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Donnacha Hogan
- Department of Urology, Western Health, Melbourne, Victoria, Australia
| | - Lana Pepdjonovic
- Department of Urology, Western Health, Melbourne, Victoria, Australia
| | - Chris Dow
- Anatomical Pathology, Western Health, Melbourne, Victoria, Australia
| | - Henry H. Yao
- Department of Urology, Western Health, Melbourne, Victoria, Australia
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Muccino E, Gentile G, Mantero S, Marchesi M, Rancati A, Zoja R. The medico-legal observation of an aggressive urogenital fibromatosis with isolated development not related to any traumatic event. Forensic Sci Int 2016; 260:e1-e6. [PMID: 26786144 DOI: 10.1016/j.forsciint.2016.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 09/26/2015] [Accepted: 01/02/2016] [Indexed: 11/29/2022]
Abstract
Desmoid tumor is a fibroproliferative neoplasm with an intermediate malignancy and it can be localized in every bodily district: some locations are considered exceptional, like the urogenital localization. The Author point out a rare case of giant idiopathic scrotal fibromatosis that was found during an autopsy. A widower, that lived alone in poor hygienic conditions, was found dead in his house. The Judicial Authority ordered the autopsy, that was performed two days later at the Medico-Legal Section of Milan University. External examinations revealed only the considerable dimension of the scrotum (cm 24 × 41). The cause of death was fixed in a cardiac tamponade due to a natural heart laceration localized in correspondence of a transmural infarction. The toxicological exam resulted negative, while the histopathological and immunohistochemical analysis qualify the scrotal mass as a desmoids tumor. Due to the absence of predisposing conditions and of fibroproliferative infiltration in bladder and retroperitoneal space, the neoplasm was configured as an idiopathic desmoid tumor. The presented case gives the reason for the discussion concerning medico-legal aspects that are typical of rare neoplasms.
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Affiliation(s)
- Enrico Muccino
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy
| | - Guendalina Gentile
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy
| | - Stefano Mantero
- Centro Nazionale delle Ricerche-Istituto di Ricerca Genetica e Biomedica (IRGB)- Istituto Clinico Humanitas, Via Manzoni 113, 20089 Rozzano MI, Italy
| | - Matteo Marchesi
- Azienda Ospedaliera Papa Giovanni XXIII-Piazza OMS 1, 24127 Bergamo
| | - Alessandra Rancati
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy
| | - Riccardo Zoja
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy.
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4
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Bösmüller H, von Weyhern CH, Adam P, Alibegovic V, Mikuz G, Fend F. Paratesticular fibrous pseudotumor--an IgG4-related disorder? Virchows Arch 2010; 458:109-13. [PMID: 20957491 DOI: 10.1007/s00428-010-0995-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 10/04/2010] [Indexed: 01/08/2023]
Abstract
Paratesticular fibrous pseudotumor (nodular periorchitis, inflammatory pseudotumor of the spermatic cord) is a rare, benign condition of unknown etiology characterized by solitary or multiple intrascrotal nodules composed of dense fibrous tissue with a variable, sometimes sparse inflammatory infiltrate. Based on certain similarities to other fibroinflammatory disorders characterized by infiltrates of IgG4-expressing plasma cells and recently subsumed under the heading of IgG4-mediated diseases, we investigated the plasma cell distribution and immunoglobulin isotypes in three cases of paratesticular fibrous and inflammatory pseudotumor. All three cases showed a high number of IgG4-positive plasma cells with an IgG4 to IgG ratio of 44-48%. This finding indicates that paratesticular fibrous pseudotumor might belong to the growing list of IgG4-related diseases, which by now includes such diverse entities as retroperitoneal fibrosis, sclerosing pancreatitis and cholangitis, Riedel's thyroiditis, or sclerosing sialadenitis.
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Affiliation(s)
- Hans Bösmüller
- Department of Pathology, Krankenhaus Barmherzige Schwestern, Seilerstätte 4, 4020, Linz, Austria.
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5
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Ruiz Liso J, Pardo López M, Vaillo Vinagre A, Gutiérrez Martín A, Bermúdez Villaverde R, Ruiz García J. [Long-term paratesticular leiomyosarcoma. Conceptual and literature review]. Actas Urol Esp 2008; 32:727-36. [PMID: 18788490 DOI: 10.1016/s0210-4806(08)73922-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION To know the incidence and clinical and pathologic characteristics of the paratesticular leiomyosarcoma (LMS) with the contribution of a case of long evolution, studying the histopathologic criteria that must be valued for this type of tumours. MATERIAL AND METHODS A 73-year-old patient includes for study with scrotal tumour present left side for 30 months. Histopathologic and imunohistochemical study is realized. Of equal form there is realized a bibliographical search of this type of tumours and their different subtypes across Medline and of not index-linked search. RESULTS Our case is the second of greater evolution of international literature, first in greater of 60 years and one of those of smaller mitotic index (1 x 50 cga). Nevertheless, his atipia, tumorlike necrosis next to 50% of the injury and its pleomorphic properties, as well as his inmunophenotypic characterization corresponds with a well differentiated LMS, degree 1 (French Federation Cancer). We have found only 107 published cases of this type of sarcomas, of them 5 in our country, which gives to a profile of the low incidence of these tumours, that within sarcomas 1% do not reach. We included the clinical and pathologic profile of such. CONCLUSIONS The long evolution of a paratesticular tumour and the absence of metastasis does not exclude its malignancy. The low incident of the LMSs in this location, implies that a protocol of actuation validate for such does not exist. We considered of great importance, its creation on the part of urologist, oncologists, radiologists and pathologists like he took control of located in retroperitoneal cavity and deep soft tissues.
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6
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Michal M, Hes O, Kazakov DV. Mesothelial Glandular Structures Within Pseudosarcomatous Proliferative Funiculitis—A Diagnostic Pitfall: Report of 17 Cases. Int J Surg Pathol 2008; 16:48-56. [DOI: 10.1177/1066896907307235] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We describe 17 cases of distinct benign pseudomalignant mesothelial proliferations, involving the spermatic cord. All cases revealed necrosis. The areas adjacent to the necrotic tissue comprised a cellular spindle cell proliferation with a haphazard arrangement of the myofibroblasts that in many areas revealed transitions into plump oval epithelioid cells and into cells with genuine epithelial appearances arranged in linear cords and often luminized into small microcysts. These epithelial cells formed isolated groups with glandular structures arising on the myofibroblastic background. Glandular structures were often situated deeply in the stroma of the spermatic cords. All cellular elements were strongly positive with AE1/AE3 antibody. All myofibroblasts stained with SM-actin antibody. Ultrastructurally, the spindle cells displayed features of myofibroblasts including actin microfilaments, as did the plump epithelioid cells that, additionally, had desmosomes, and the cords of the epithelial cells including those forming glandular structures had characteristics of mesothelias including the characteristic microvilli.
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Affiliation(s)
- Michal Michal
- Sikl's Department of Pathology, Laboratore Spec. Diagnostiky Medical Faculty Hospital, Plzen, Czech Republic,
| | - Ondrej Hes
- Sikl's Department of Pathology, Laboratore Spec. Diagnostiky Medical Faculty Hospital, Plzen, Czech Republic
| | - Dmitry V. Kazakov
- Sikl's Department of Pathology, Laboratore Spec. Diagnostiky Medical Faculty Hospital, Plzen, Czech Republic
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Algaba F, Mikuz G, Boccon-Gibod L, Trias I, Arce Y, Montironi R, Egevad L, Scarpelli M, Lopez-Beltran A. Pseudoneoplastic lesions of the testis and paratesticular structures. Virchows Arch 2007; 451:987-97. [PMID: 17805564 PMCID: PMC2082069 DOI: 10.1007/s00428-007-0502-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 07/31/2007] [Accepted: 08/15/2007] [Indexed: 01/26/2023]
Abstract
Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia.
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Affiliation(s)
- F Algaba
- Pathology section, Fundació Puigvert, Barcelona, Spain.
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8
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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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9
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Shi B, Zhu Y, Xu Z, Liu Y, Zheng B, Qi T. Aggressive fibromatosis in the urological system. Report of two adult patients and review of the literature. Urol Int 2006; 78:93-6. [PMID: 17192743 DOI: 10.1159/000096945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Accepted: 12/30/2005] [Indexed: 11/19/2022]
Abstract
Aggressive fibromatoses (AF) are locally aggressive neoplasms that do not metastasize but are frequently associated with one or more recurrences and subsequent associated morbidity. AF in the urological system is quite rare and has mainly been described in single case reports or as isolated cases in a large series of extra-abdominal desmoid tumors. We report 2 cases of AF in the bladder and scrotum, and provide a review of similar published cases.
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Affiliation(s)
- Benkang Shi
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
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10
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Kim TH, Bae SR, Ok YC, Shin CW, Lee KS, Kong GS, Rha SH, Yoon JH, Cho WY. Fibrous Pseudotumor in the Testicular Tunica. Korean J Urol 2006. [DOI: 10.4111/kju.2006.47.10.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Tae Hyo Kim
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | - Sang Rak Bae
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | | | - Chan Wook Shin
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | - Ki Soo Lee
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | - Geun Soo Kong
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | - Seo Hee Rha
- Department of Pathology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | - Jin Han Yoon
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
| | - Won Yeol Cho
- Department of Urology, College of Midicine, Dong-a University College of Medicine, Busan, Korea
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11
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Abstract
A surgical case of proliferative funiculitis (pseudosarcomatous myofibroblastic proliferation of the spermatic cord) with a prominent mast cell infiltration is reported. A 67-year-old man with a history of right inguinal herniorrhaphy 7 years earlier was operated on for diffuse swelling of the inguinal region and scrotum. A large lipoma was found in the inguinal region, and a nodular lesion, measuring 2.7 cm in maximal dimension, was firmly attached to the right spermatic cord. The nodular lesion showed diffuse proliferation of fibroblasts and myofibroblasts associated with the deposition of collagen. A diffuse infiltration of numerous mast cells was found throughout the lesion. Lesions that belong to the group of inflammatory pseudotumors are rarely accompanied by a prominent mast cell infiltration, and the differentiation from mast cell neoplasms is often problematic in such cases. The present case is the first example of proliferative funiculitis associated with this rare phenomenon.
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Affiliation(s)
- Masayuki Shintaku
- Department of Pathology, Osaka Red Cross Hospital, Tennoji, Osaka, Japan.
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12
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Abstract
Paratesticular liposarcomas are rare and typically reported as isolated cases or as components of larger studies of liposarcomas. We studied a series of these tumors. All cases of paratesticular liposarcomas were retrieved from the archives of the Royal Marsden Hospital and the Johns Hopkins Hospital. Slides were reviewed and clinical information obtained. There were 30 paratesticular liposarcomas from men aged 41-87 years (mean 63 years; median 65 years) that involved the spermatic cord (23, 76%), testicular tunics (6, 20%), and epididymis (1, 4%). Tumors ranged from 3 to 30 cm (mean 11.7 cm; median 10 cm). Nineteen were well-differentiated liposarcomas (WDLs) and 10 were dedifferentiated liposarcomas (DDLs, five with high-grade and five with low-grade dedifferentiation). One was a myxoid/round cell liposarcoma with 70% round cell areas. All patients were treated by radical orchiectomy. One patient with WDL received radiation after his second recurrence and the myxoid/round cell liposarcoma received radiation and chemotherapy. Follow-up information was available for 16 of the patients, including 10 WDLs (range 24-216 months, mean 106 months), 5 DDLs (14-30 months, median 24 months), and for the myxoid/round cell liposarcoma (14 months) (range for all cases 14 months to 22 years; mean 87 months, median 36 months). Six of the WDLs (60%) recurred at 2, 4, 6, 10, 18, and 21 years (median 8 years). The lesion that recurred at 18 years (case no. 6) displayed foci of high-grade dedifferentiation in the recurrence, although the patient was disease free at 19 years. One patient with WDL had two recurrences at 4 and 7 years, and another had six recurrences over a 17-year period. Only one example of DDL recurred, at 30 months; another patient, who refused therapy for 15 years, had a primary tumor 30 cm in diameter, displayed pulmonary metastases 1 month after excision, and died after 14 months. The patient with MRCL had abdominal metastases after 1 year and was alive at 14 months. In summary, paratesticular WDL had a prolonged course with recurrences in more than half the cases, sometimes late. There were no metastases and the overall prognosis was good. One DDL recurred and only one of five (20%) developed metastases, but the mean follow-up for DDL was only 24 months.
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13
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Fisher C, Goldblum JR, Epstein JI, Montgomery E. Leiomyosarcoma of the paratesticular region: a clinicopathologic study. Am J Surg Pathol 2001; 25:1143-9. [PMID: 11688573 DOI: 10.1097/00000478-200109000-00004] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The behavior of leiomyosarcoma (LMS) is site related, but there are limited data on such tumors presenting in the paratesticular region. Cases diagnosed as LMS of the paratesticular region from the files of three institutions were reviewed. Immunohistochemistry was performed in cases with available blocks, and follow-up information was obtained. From 31 cases originally diagnosed as LMS, 24 were retained after review. These were from men aged 34-86 years (mean 62 years; median 64 years) and involved the testicular tunica (10), spermatic cord (10), scrotal subcutis and dartos muscles (1 each), and the epididymis (1). Tumors ranged in size from 2-9 cm (mean 5 cm; median 4 cm). On immunohistochemical staining they expressed muscle-specific actin (13 of 14), smooth muscle actin (10 of 10), desmin (16 of 17), and CD34 (3 of 9); all of the latter three were strongly desmin-positive. Focal reactivity for cytokeratin (3 of 8) and S-100 protein (1 of 8) was seen. Follow-up information was available in 14 patients. Four (29%) had recurrences, in one case four times. Metastases to lymph nodes, lungs, or liver were seen in four patients (29%), of whom two had prior recurrences. Ten were alive with no evidence of disease (ANED), and four were dead of disease (DOD). Comparing outcome with tumor grade, all seven patients with grade 1 tumors (of whom two had recurrences) and all three with grade 2 tumors were ANED, whereas all four patients with grade 3 tumors were DOD. In summary, paratesticular LMSs are rare neoplasms. The majority in this site are low-grade, although high-grade lesions behave aggressively.
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Affiliation(s)
- C Fisher
- Department of Pathology, the Royal Marsden NHS Trust, London, UK.
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14
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Tobias-machado M, Corrêa Lopes Neto A, Heloisa Simardi L, Borrelli M, Wroclawski ER. Fibrous pseudotumor of tunica vaginalis and epididymis. Urology 2000; 56:670-2. [PMID: 11018636 DOI: 10.1016/s0090-4295(00)00736-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
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.
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Affiliation(s)
- M Tobias-machado
- Department of Urology, Medical School of the ABC Foundation, Padre Anchieta University Hospital, Santo André, São Paulo, Brazil
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15
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Barton JH, Davis CJ, Sesterhenn IA, Mostofi FK. Smooth muscle hyperplasia of the testicular adnexa clinically mimicking neoplasia: clinicopathologic study of sixteen cases. Am J Surg Pathol 1999; 23:903-9. [PMID: 10435559 DOI: 10.1097/00000478-199908000-00007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sixteen cases of a largely unrecognized benign cause for an intrascrotal mass are reported herein. These cases represent a nonneoplastic excess of native smooth muscle in the paratestis or spermatic cord growing between or around vessels or efferent ducts. The patients ranged in age from 46 to 81 years, with a mean age of 63 years. The size, available in 10 of the cases, ranged from 6 mm to 7 cm, with a mean of 2.5 cm; there was no side predilection. Microscopically, the lesions consisted of fascicles of smooth muscle, growing in a periductal, perivascular, interstitial, or mixed pattern. The cohesive, interlacing growth pattern of a leiomyoma was missing in all cases. The cause of this lesion is not apparent, although microscopic epididymal or vas deferens duct ectasia in some cases suggests a possible obstructive etiology. In any case, these are benign and without clinical significance after excision and correct diagnosis. Follow-up was available in 13 patients with no recurrences observed from 1 month to 16 years postoperatively.
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Affiliation(s)
- J H Barton
- Department of Pathology, Adventist HealthCare Laboratory Services, Shady Grove Site, Rockville, Maryland, USA
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16
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Abstract
Benign fibromatous tumor (fibroma) of the urogenital tract is a distinctive pathologic entity occurring in the testis, paratesticular structures and renal peripelvis. We report a well-circumscribed tumor replacing the cortex and the medulla of more than half of the upper kidney, radiographically thought to be renal cell carcinoma. Histologically, the tumor was characterized by a variable cellularity and was composed of bland spindle-shaped cells loosely dispersed in a fibromyxoid to densely fibrous stroma in which calcifications and chronic inflammation were not observed. Immunocytochemistry showed that cells were positive for vimentin and, only focally, stained positive for desmin and alpha-smooth muscle actin. Differential diagnosis included a wide spectrum of benign and malignant spindle cell tumors. The clinicopathologic features were consistent with benign fibromatous tumor (fibroma) of the kidney. To our knowledge, this is the first case of benign fibromatous tumor (fibroma) of the kidney reported in the English literature.
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Affiliation(s)
- G Magro
- Istituto di Anatomia ed Istologia Patologica, Universitá di Catania, Italy
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17
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Jones MA, Young RH, Scully RE. 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. Am J Surg Pathol 1997; 21:296-305. [PMID: 9060599 DOI: 10.1097/00000478-199703000-00005] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
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.
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Affiliation(s)
- M A Jones
- Department of Pathology, Maine Medical Center, Portland 04102, USA
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