Fibrous pseudotumor of the tunica vaginalis testis: imaging appearance

Fibrous pseudotumor is a benign paratesticular tumor that typically presents as a painless mass of the hemiscrotum. Because this tumor can mimic a malignant process, it is usually not diagnosed preoperatively. We describe a case of fibrous pseudotumor of the tunica vaginalis, demonstrating the ultrasound and magnetic resonance image (MRI) appearance with pathologic correlation.The Chief, Bureau of Medicine and Surgery, Navy Department, Washington, DC, Clinical Investigation Program sponsored this report, #84-16-1968-486, as required by HSETCINST 6000.41A. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.     

睾丸鞘膜纤维性假瘤1例

患者男,58岁。阴囊内扪及小肿块一周来诊。查体:发现右侧阴囊内小结节,质硬,无压痛,结节与睾丸能够分开。彩超检查:双侧睾丸与附睾大小形态正常,右侧睾丸鞘膜后壁中部可见局部鞘膜增厚,范围约0.4cm×0.9cm,其余部位的鞘膜回声及厚度正常。右侧附睾头部可见一约为1.0cm×0.9cm等     

Malignant mesothelioma of the tunica vaginalis testis: unusual sonographic appearance

Malignant mesothelioma of the tunica vaginalis testis is a rare and aggressive neoplasm. It is similar to malignant mesothelioma of the peritoneum, usually associated with asbestos exposure. We present an unusual case in which the tumor was a mix of a hypoechoic solid nodule and a cystic component with low-level internal echoes.     

Diagnosis of malignant mesothelioma of the tunica vaginalis testis by ultrasound-guided fine-needle aspiration

Malignant mesothelioma of the tunica vaginalis testis is a very rare tumor that is not usually diagnosed until surgery is undertaken. In only a few cases has the correct diagnosis been obtained preoperatively by cytologic examination of fluid from the hydrocele. We describe a case of mesothelioma of the tunica vaginalis testis that was suspected on sonography because of the presence of a hydrocele and focal nodularities. The diagnosis was confirmed preoperatively by ultrasound-guided fine-needle aspiration cytology aimed at 1 of the focal nodularities. Our patient was an 85-year-old man with concomitant cancer of the sigmoid colon; because of his age and the spread of his colon cancer, we did not remove the scrotal lesion. We recommend consideration of ultrasound-guided fine-needle aspiration cytology of the solid masses instead of the fluid from the hydrocele in cases of suspected malignant mesothelioma of the tunica vaginalis testis.     

Metastatic small cell carcinoma to the testis

Testicular neoplasms comprise 1% of all malignancies in men, with less than 3% of these malignancies due to metastatic disease. We report a case of a 51-year-old man with a history of left pneumonectomy done 2 years earlier for small cell carcinoma of the lung; the patient came to his primary care physician for routine follow-up. Physical examination was significant for a left testicular mass, which on final pathology was diagnosed as metastatic small cell carcinoma.     

Sonographic findings of fibrous pseudotumor of the tunica vaginalis

We report the sonographic findings in a case of fibrous pseudotumor of the tunica vaginalis. Scrotal gray-scale sonography revealed a well-margined, hypoechoic mass with an onion ring appearance and central calcifications in the left scrotum. Color Doppler sonography showed no blood flow within the mass. The pathological examination revealed a fibrous pseudotumor with a paucicellular and fibroblastic proliferation of cells within a hyalinized collagenous stroma.     

Well‐differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance

Paratesticular mesothelioma is a rare differential diagnosis in the presence of scrotal hydrocele. A 17‐year‐old boy presented with a 3‐year history of progressive hydrocele. Sonography revealed a large left paratesticular mass within the hydrocele. Serum tumor markers were negative. Left hydrocelectomy was performed and pathological analysis of the epididymal mass revealed a well‐differentiated papillary mesothelioma. We discuss the sonographic and pathological findings of this rare neoplasm.     

Leiomyoma arising from the tunica albuginea of the testis: sonographic findings

Leiomyomas are benign neoplasms that may arise from any structure or organ containing smooth muscle. The majority of genitourinary leimyomas are found in the renal capsule, but this tumor has also been reported in the epididymis, spermatic cord, and tunica albuginea. Sonography is the imaging modality of choice for evaluating intrascrotal pathology, but the sonographic appearance of leiomyomas arising from the tunica albuginea have rarely been reported. We report a case of such a leiomyoma that was diagnosed sonographically.     

Metastatic disease involving the stomach.

Metastatic disease involving the stomach is an unusual and difficult clinical problem. A review of 1010 autopsies of patients with cancer disclosed 17 cases of gastric metastases (an incidence of 1.7%), with breast cancer, lung cancer, and melanoma being the most frequent primaries. The clinical manifestations of epigastric pain, melena, and anemia are nonspecific, necessitating radiographic examination of the gastrointestinal tract. The radiographic findings are usually sufficient to suggest the diagnosis.