A Case of Fibrous Pseudotumor of the Paratesticular Region
A 78-year-old male who had a medical history of hydrocele formation five years earlier presented to our institution with a hard nodule in the left inguinoscrotal region that had existed for three years. The patient had not sought any medical treatment for the hydrocele and it had resolved spontaneously. On physical examination, the nodule was mobile, hard, and non-tender and measured 3 cm in diameter. A radical orchiectomy was performed, and the nodule, along with the testis and spermatic cord, was excised out through an inguinal incision (). Grossly, the testis, cord, and nodule could be identified separately. The cord was thick and nodular over an area of 2.5×2.5 cm, and a cut section of the nodule was solid and grey-white. On microscopic examination, the lesion showed spindle-shaped cells with a round-to-oval nucleus and a moderate quantity of eosinophilic cytoplasm with indistinct cytoplasmic margins (). Sections from the testis, epididymis, and vas deferens were unremarkable. On immunohistochemistry, the cells were reactive with smooth muscle antigen and muscle specific actin (), and negative for S-100, keratin, and CD34. A final diagnosis of paratesticular fibrous pseudotumor was made.