林弋筑、蔡昇翰、張心湜

振興醫療財團法人振興醫院 泌尿部

Yi-Chu Lin, Sheng-Han Tsai, Shin-Shu Chang

Department of Urology, Cheng Hsin General Hospital, Taipei, Taiwan

 

A 17 year-old boy found left testicular mass with tenderness by himself, and then visited our urology outpatient department for help. At OPD, physical examination showed a hard nodule in left testis with tenderness, B-HCG and AFP were normal. Then sonography of scrotum and CT of abdomen was arrange for further evaluation. Both of image examinations showed a small hypervascular nodule in lower pole of left testicle, but no definite lymphadenopathy or mass in the retroperitoneal space or inguinal regions were found. For hypervascular tumor of testis, differential diagnosis included vascular malformation, or germ cell tumor. As germ cell tumor cannot be rule out, surgical intervention was suggested. The patient was admitted and operation was arranged on. During operation, a well circumscribed tumor in left scrotum near epididymal tail was found, the tumor was homogenous, brownish and easy bleeding, tumor size was about 1.5 x1.5 cm, frozen section of tumor was sent and showed hemangioma with low N/C ratio microscopically. Therefore, tumor excision with testicle sparing was done according to frozen section result. The final pathology report of the tumor was capillary hemangioma, which was a benign testicular tumor.

Testicular capillary haemangioma is an exceptionally rare tumor. Capillary haemangioma of the testis can be similar to malignant testicular tumors on clinical presentation, as well as on ultrasonography and computed tomography, and therefore should be included in the intraoperative differential diagnosis. Because of the benign nature of this lesion, conservative surgical treatment by means of tumor enucleation with preservation of the testis is possible, if intraoperative examination of frozen sections of representative tissue can be performed.