Benign fibrous pseudotumor of tunica vaginalis testis

Parker, Patrick; Pugliese, J; Allen, Robert C.

doi:10.1016/j.urology.2006.02.034

Cited by 25 publications

(29 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients typically present with a painless scrotal lump of widely varying size or unilateral scrotal swelling (25). Pseudotumors are usually associated with hydrocele, history of trauma, or infection, particularly with the bacterium Schistosoma hematobium (26).…”

Section: Solid Lesions Fibrous Pseudotumor Of the Testismentioning

confidence: 99%

Non neoplastic intratesticular masses

Bhatt¹,

Jafri²,

Wasserman³

et al. 2009

Diagn Interv Radiol

View full text Add to dashboard Cite

High-frequency ultrasonography is the first modality of choice for the evaluation of scrotal pathology. The use of high-frequency ultrasound is increasing, allowing detection and better characterization of many benign intrascrotal lesions that can be treated with non-surgical management or testicular-sparing surgery.This pictorial essay presents gray-scale and color-flow Doppler features of non-neoplastic intratesticular masses. For ease of understanding, the review is organized into three major categories: cystic, vascular, and solid non-neoplastic masses. Table summarizes the key sonographic features, each with recommended management. Sonographic anatomy of the testisThe normal adult testes in each hemi scrotum are symmetric in size and measure approximately 5x3x2 cm. On ultrasound, a normal testis is identified by the presence of homogeneous, medium-level echoes and is contained by a fibrous sheath called the tunica albuginea. The tunica albuginea is identified on ultrasound as a thin echogenic line around the testis and is externally covered by the tunica vaginalis. The tunica vaginalis consists of visceral and parietal layers that are normally separated by a few milliliters (2-3 mL) of fluid. The tunica attaches to the scrotal wall at the posterolateral aspect of the testis. From the posterior aspect of the testis, the tunica albuginea invaginates within the testis to form an incomplete septum, called the mediastinum testis. Sonographically, the mediastinum testis appears as an echogenic band of variable thickness that extends across the testis in the longitudinal axis (Fig. 1). Multiple fibrous septa extend from the mediastinum into the testis, dividing it into 250 to 400 lobules. Spermatogenesis occurs within the seminiferous tubules contained within these lobules. The seminiferous tubules open into dilated spaces called the rete testis within the mediastinum via the tubuli recti. The normal rete testis can be seen on high-frequency US in 18% of patients. (1). The rete testis drains into the epididymis via 10 to 15 efferent ductules.There are four testicular appendages (remnants of the mesonephric and paramesonephric ducts): the appendix testis (hydatid of Morgagni), the appendix epididymis, the vas aberrans, and the paradidymis. The appendix testis and the appendix epididymis are commonly seen on scrotal US. The appendix testis is a small ovoid structure usually at the upper pole of the testis in the groove between the testis and the epididymis, better seen by the presence of fluid around the testis.The testes are supplied by testicular arteries that arise from the abdominal aorta. The testicular arteries enter the spermatic cord at the deep inguinal ring and continue along the posterior surface of the testis, penetrating the tunica albuginea and forming the capsular arteries that course through the tunica vasculosa, which underlies the tunica ABDOMINAL IMAGING PICTORIAL ESSAY Imaging of non-neoplastic intratesticular massesShweta Bhatt, Syed Zafar H. Jafri, Neil Wasserman, Vikram S. Dogra ABSTRACTThe u...

show abstract

Section: Solid Lesions Fibrous Pseudotumor Of the Testismentioning

confidence: 99%

Non neoplastic intratesticular masses

Bhatt¹,

Jafri²,

Wasserman³

et al. 2009

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…8,9 These lesions comprise about 6% of paratesticular masses, second to adenomatoid tumours. 1,10 Still, their relatively rare occurrence has meant that most available information comes from case reports and series. Decoste et al…”

Section: Discussionmentioning

confidence: 99%

“…1,3,8 Mostafi and Price endorsed the term "fibrous pseudotumour" due to the belief that these lesions are the result of benign reactive processes in the testicular tunics. This description encompassed several variants and synonyms used to describe inflammatory and fibrotic paratesticular lesions, 2,11 and has since been included in most textbooks and guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…They frequently involve the tunica vaginalis, with rarer cases arising from the tunica albuginea, epididymis and spermatic cord. [1][2][3][4][5][6] Peak incidence occurs in the third decade of life, but reports exist in all age groups. 7 Although patients may report a history of testicular trauma, infection or hydrocele, the similarity in presentation to malignancy often results in radical surgery with diagnosis made on the resected specimen.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Paratesticular fibrous pseudotumour: Intraoperative frozen section analysis can help prevent unnecessary orchiectomy

DeCoste

Carter

Bagnell

et al. 2015

CUAJ

View full text Add to dashboard Cite

Paratesticular fibrous pseudotumours are rare intrascrotal lesions, most frequently affecting the testicular tunics. They are benign in nature; however, their pathogenesis is not completely understood. Presenting features are similar to testicular malignancy, which may result in unnecessary radical surgery. It has been suggested that additional diagnostic imaging combined with frozen section analysis may help prevent orchiectomy in these patients. We describe a case of paratesticular fibrous pseudotumour in a 40-year-old male treated with testicle-sparing surgery aided by intraoperative frozen section analysis. IntroductionParatesticular fibrous pseudotumours (PFPs) are rare, benign lesions believed to result from fibroinflammatory processes. They present most commonly as painless scrotal masses and occur as single or disseminated nodules. They frequently involve the tunica vaginalis, with rarer cases arising from the tunica albuginea, epididymis and spermatic cord. [1][2][3][4][5][6] Peak incidence occurs in the third decade of life, but reports exist in all age groups.7 Although patients may report a history of testicular trauma, infection or hydrocele, the similarity in presentation to malignancy often results in radical surgery with diagnosis made on the resected specimen. 2-4 Case report Clinical findingsA 40-year-old man presented with a history of right hemiscrotal fullness and palpable nodules. The nodules grew tender over time. Physical examination revealed several small, right-sided scrotal lesions. Interpretation of scrotal ultrasound described microlithiases, and an enlarged, lobulated and echogenic right epididymis. There was one small epididymal cyst measuring 3 mm. The patient was booked for surgical exploration, which revealed solid nodules lining much of the tunica vaginalis. A specimen sent for frozen section revealed heavily collagenized, hypocellular tissue with chronic inflammatory infiltrate. No malignancy was identified. About one-third of the tunica vaginalis was removed and the remainder of the testicle was spared (Fig. 1). Pathological findingsGross examination revealed tan-grey tissue measuring 7.0 × 3.5 × 1.2 cm, with a roughened surface and opposing smooth, pearly grey tunica/mesothelial surface containing many polypoid projections (Fig. 2). Nodules measured up to 1.1 cm in greatest dimension. Microscopic examination revealed hypocellular tissue composed of thick collagen bundles with areas of hyalinization, thick and thin walled vessels and a background mixed inflammatory infiltrate consisting primarily of plasma cells with admixed lymphocytes and occasional mast cells (Fig. 3). There were occasional lymphoid aggregates and plump fibroblasts. Several vessels demonstrated concentric perivascular fibrosis. Immunohistochemistry revealed monokeratin-and vimentinpositive cells between the collagen bands. These cells also stained weakly for D2-40 and CD34, consistent with fibroblasts/myofibroblasts. LCA stain highlighted the background inflammatory cells and lymphoid aggregates. V...

show abstract

“…Tumor size at presentation can range from 1 to 10 cm. 2 Most patients report a history of hydrocele, trauma, or infection. In most reports, hydrocele represents the most frequently associated finding with the lesion and has been found in nearly 50% of fibrous pseudotumor cases.…”

Section: Case Reportmentioning

confidence: 99%

Paratesticular Fibrous Pseudotumor -A Rare Entity

Srivastava¹

2017

JMSCR

View full text Add to dashboard Cite

Benign fibrous pseudotumor of tunica vaginalis testis

Cited by 25 publications

References 7 publications

Non neoplastic intratesticular masses

Non neoplastic intratesticular masses

Paratesticular fibrous pseudotumour: Intraoperative frozen section analysis can help prevent unnecessary orchiectomy

Paratesticular Fibrous Pseudotumor -A Rare Entity

Contact Info

Product

Resources

About