[PP-247]

Giant fibrolipoma of the spermatic cord

Turgay Kaçan, Muhammet Fatih Kılınç, Ali Ayyıldız
University of Health Sciences, Ankara Training and Research Hospital,Department of Urology, Ankara

INTRODUCTION

Fibrolipoma, an uncommon histological subtype of lipoma, is considered a benign mesenchymal neoplasm. Fibrolipoma of the scrotum is an even more rare.

CASE REPORT

A 56 years old male was applied for our department because of right hemi-scrotal mass. On the examination of the scrotum, a painless, mobile, and separate from testicle mass was identified posterolateral on the right testicle. The inguinal lymph nodes were not palpable. Laboratory tests were normal and serum markers for testicular cancer (hCG,AFP,LDH) were within normal limits. He was examined with ultrasonography (US) and Magnetic Resonance Imaging(MRI). Ultrasonography showed a large hyperechoic scrotal mass separated from the ipsilateral testis. Tumorectomy was performed. Grossly, the tumor was well-defined, yellowish, firm tumor measuring 9,5*9,5*2 cm. The tumor had a thin capsule. The tumor was attached to the right spermatic cord, and was remote from the the right testis and epididymis. Microscopically, the tumor was composed of mature adipose tissue and collagenous fibrous tissue. Lipoblast were not recognized. The tumor was diagnosed as giant fibrolipoma of the right spermatic cord.

DISCUSSION

Primary paratesticular tumors are rare. Lipoma is the most common benign tumor of the paratesticular area,usually arising from the spermatic cord. Our case differs from classic lipoma since the tumor was composed of both adipose tissue and collagenous fibrous tissue.
Intrascrotal tumors provide a diagnostic challenge for urologist. A detailed history, physical examination and use of imaging techniques are keys to the diagnosis. US is very beneficial in identifying the location of the mass in relation to the scrotal components but not so for severalizing benign from malignant lesions. Surgical excision is the treathment of choise. There is no argument that scrotal fibrolipomas diverge in terms of management and prognosis from other subtypes of lipoma.
To our knowledge the case described here is the fifth scrotal fibrolipoma that has been reported in the literatüre.


Resim 1a ve 1b

Figure 1 a) Gross appearance of the tumor. b). Microscopic appearance of the tumor under H&A stain. The tumor is composed of mature adipose and collagenous fibrous tissue.