睪丸肌瘤

劉致毅1,2、詹鎮豪1,2

 1高雄市立小港醫院泌尿科； 2高雄醫學大學附設中和紀念醫院 泌尿部

Leiomyoma of the testis

Chih I Liu1,2, Jhen Hao Jhan1,2

 1Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaosjiung, Taiwan;

 2Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung,Taiwan

Present Illness: A 42-year-old gentleman suffered from enlarged left testis for couple of months. The left testis lesion was painless. He denied fever, hematuria, hematospermia, dysuria, fever, decreased urine output, flank pain, colic pain. On physical examination, the texture of the left testis tumor was hard with well-shaped border, no tenderness was noted.

Image and lab: A testis sonography was performed, which revealed that the left testis enlarged with a heterogenous pattern. His urine analysis showed no abnormalities, and the serum data and urine culture showed no signs of infection. Tumor markers of human chorionic gonadotropin β, alpha-fetoprotein, lactate dehydrogenase were within normal range. Magnetic resonance imaging showed one paratesticular tumor adjacent to the left testis.

Operation: After explaining to the patient about higher chances of malignancy comparing to benign lesion in the setting of a testis tumor. We performed radial inguinal orchiectomy, which is the preferred initial management of suspect testicular cancer. During the surgery, the entire left testis along with the tumor lesion was resected and removed through the inguinal wound. There appeared to be a border between the testis and the paratesticular tumor.

Pathology: The pathology diagnosis was leiomyoma of left testis, with the tumor bulging from the surface of testis. Immunohistochemical studies show desmin(+), SOX10(-), CD117(-) in tumor cells. There were no significant nuclear atypia, necrosis or mitotic activity noted.
Conclusion: We presented a case of 42-year-old gentleman with a left testis tumor who underwent left radial inguinal orchiectomy. The pathology result revealed leiomyoma of the left testis.