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Abstract

Paratesticular fibrous pseudotumor (PFPs) is an uncommon intra-scrotal mass that originated from tunica vaginalis and resulted in a reactive fibrous proliferation after a history of inflammation, infection, trauma, or hydrocele. We report here on a case of a 17-year-old man with a mass in the hemiscrotum that was found to be PFP in the orchidectomy specimen pathologic examination. The diagnosis of PFPs, before and during the operation, can be complicated despite it being a benign tumor. Radical orchidectomy is usually performed for these types of lesions. A frozen section intraoperatively is essential to avoid unnecessary radical orchidectomy and preserve testicle.

Section snippets

BACKGROUND

Para testicular tumors, which originate from the connective tissue surrounding the spermatic cord, epididymis, or testis, are uncommon intra-scrotal tumors.¹ However, around 6% of Para testicular lesions are Paratesticular fibrous pseudotumors (PFPs).² PFPs are benign extra-testicular tissue proliferation and usually grow from the tunica vaginalis.³ This proliferation happens after inflammation, infection, or trauma that leads to reactive fibro-inflammatory proliferation with the formation of

CASE PRESENTATION

A 17-year-old male patient presented with left scrotal swelling of one-year duration, gradually increasing in size. He developed constant pain and discomfort and sought medical advice during the last 4 months.

He is a single male, barber, with no history of sexual intercourse, infection, or trauma. No lower urinary tract symptoms (LUTS). Also, his past medical and surgical histories are both unremarkable.

Physical examination revealed an immobile firm mass in the left hemiscrotum. Abdominal and

DISCUSSION

PFPs is an uncommon intrascrotal mass that originated from tunica vaginalis and resulted in a reactive fibrous proliferation after a history of inflammation, infection, trauma, or hydrocele. The first case of PFP was in 1904 and was reported by Balloch.^8,9 Moreover, Williams and Banerjee found only 7 cases (6.1%) of PFPs form a total of 114 paratesticular tumors.¹⁰

PFPs can be detected at any age with a peak of incidence among those who are in their 30s.¹¹ Our patient was 17 years old and

CONCLUSION

The diagnosis of PFPs, before and during the operation, can be difficult and complicated despite it is a benign tumor. Radical orchidectomy is usually performed for these types of lesions. A frozen section intraoperatively is essential to avoid unnecessary radical orchidectomy and preserve the testicle. We highlight the importance of avoiding radical orchidectomy when the risk of malignancy is doubtful.AUTHORS CONTRIBUTIONS

Mustafa I. Al-Shalah, Sadam Alabdallat, and Ashraf Alzayed: Case report design and patient medical and surgical care. Neebal abunaser, and Almu’atasim Khamees: Wrote the initial draft of the case report. Ashraf Alzayed, Neebal abunaser, and Almu’atasim Khamees: revised the manuscript. All authors read and approved the content of the submitted case report.

Acknowledgments

We want to thank our patient for consenting to the publication of the article.

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