Schwannoma of the Scrotum: Case Report and Review of the Literature
A 45-year-old male presented with a history of gradually increasing, painless, left-sided testicular swelling lasting 6 months. On physical examination, a firm mass measuring 9.5 cm×9.5 cm was observed at the root of the scrotum, close to the testis. The patient had no neurological symptoms and careful evaluation for neurofibromatosis was negative. No lymphadenopathy was detected. The patient also had a friction ulcer over the scrotal skin and a provisional clinical diagnosis of an epididymal or testicular tumor was made.\nUltrasonographic examination revealed a well-circumscribed heterogeneous scrotal mass that was well separated from the epididymis and testis and isoechoic in echotexture (). Preoperative evaluation for tumor markers of testicular tumors, which included alpha-fetoprotein, beta-hCG, and lactate dehydrogenase, were all negative. Curative surgical excision of the left scrotal mass was undertaken for removal of the tumor and a definitive diagnosis. Partial scrotectomy was done, which revealed a firm, nodular whitish lesion attached to the scrotal sac not involving the testis. The testis was spared and the scrotal mass was excised. The specimen submitted for histopathological examination consisted of an oblong, firm scrotal mass that measured 8.5 cm×8.5 cm×6.0 cm. The cut surface was whitish, lobulated, and glistening, with central yellow-brown areas (). Microscopic examination showed two different patterns: Antoni type A and Antoni type B areas. Antoni A areas are quite cellular and are composed of spindle cells that are often arranged in a palisading pattern or in an organoid pattern representing Verocay bodies. Antoni B areas are hypocellular with abundant edematous fluid-forming cystic spaces (, ).