罕見良性陰囊內脂胚細胞瘤:案例報告與文獻分析

蔡長佑、陳丕哲、周詠欽、沈正煌

嘉義基督教醫院 外科部 泌尿科

A Rare Benign Tumor of Intrascroal Lipoblastoma: A Case Report and Literature Review

Chang-Yu Tsai, Pi-Che Chen, Yeong-Chin Jou, Cheng-Huang Shen

Divisions of Urology, Department of Surgery, Chia-Yi Christian Hospital

Introduction: 

    Lipoblastoma is a benign rare tumor usually seen in infancy or early childhood. Lipoblastoma may grow anywhere over the body, including the extremities, trunk, head, neck, retroperitoneum, mesentery and the omentum. It seldom occurs in the scrotum or groin area. In this article, we present a case of intrascrotal lipoblastoma.

Case presentation: 

    This is an 11-year-old boy with a  history of G6PD deficiency. He came to our outpatient department due to painless right scrotal enlargement. According to the patient and his family, it was first noted as a small nodule 2-years ago which then grew into a large mass measuring about 8*8cm. Ultrasound was performed which showed heterogenous echogenicity with ill-defined margins, thus testicular malignancy was suspected. Subsequent blood tests however revealed normal AFP and beta-HCG levels. Further Computer Tomography of the scrotum showed right testicular liposacraoma with left para-aortic metastatic lymphadenopathy. Operation of right radical orchiectomy was then conducted after shared decision making. The ultimate pathological report showed intrascrotal lipoblastoma. After the surgical operation, the patient was then smoothly discharged on postoperative day 6.

Discussion: 

    Lipoblastoma is a rare benign tumor, occurring in infancy and early childhood usually before 3-years of age. It has a male predominance and usually presents with painless mass or swelling. Initial diagnosis with the use of sonography or computed tomography may be difficult, thus surgical resection of the mass were usually conducted in these patients. The recurrence rate of lipoblastomas at other anatomical sites varies with some noted to be as high as 80%. However recurrence of intrascrotal lipoblastoma was not mentioned, probably due to the low incidence of scrotal lipoblastoma. Future surgical strategy may include an initial frozen biopsy to rule out malignancy, before conducting mass excision or orchiectomy.

Conclusions: