A 52-year-old male presented with complaints of a painless nodule in right scrotal sac for last 2-years that was gradually but very slowly increasing in size. There was no history suggestive of urinary infection, genitor-urinary tuberculosis or epididymo-orchitis. Examination revealed a pea-sized firm, well-marginated, smooth swelling present at the lower pole of testis but that could not be separated with epididymis. Testicular sensation was normal and cord and rest of the epididymis was normal. Serum level of α-fetoprotein and β-HCG were normal. Scrotal ultrasonography revealed a solid mass at the lower pole of right testis that was relatively hyperechoic as compared to the testicular parenchyma []. Scrotal MRI revealed a well-defined lenticular lesion at lower part of right testis. The lesion displayed signals isointense to slightly hypointense on both T1- and T2-weighted images with adjacent hypointense band. The interface with the testis was maintained []. Fine-needle aspiration from the mass revealed absence of malignant cells. In view of long clinical history, negative tumor markers, findings typical of adenomatoid tumor on sonography and MRI, as reported previously,[] and absence of malignant cells on cytology local excision was performed under local anesthesia through inguinal incision. At exploration, there was a hard mass on the lower pole separate from the epididymis. Histopathology confirmed it to be an adenomatoid tumor.
A 12-year-old boy presented to the andrology department in June 2013 with left testicular pain that he had had for 6 months. There was no history of recent trauma, infection, hydrocele, or undescended testis. He denied having any urinary or constitutional symptoms. Physical examination revealed a hard, tender, 10 mm × 10 mm × 8 mm testicular nodule in the superior aspect of the left testis. The contralateral testicle was normal.\nScrotal ultrasonography (8 to 12 linear array transducer, LOGIQ P5, GE Healthcare, New York, New York State, USA) revealed 8 mm × 10 mm, hypoechoic homogeneous solid mass with unclear margin at the junction of the epididymis and left testis (). Serum tumor markers, including alpha-fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase, were all within normal limits. All preoperative laboratory tests, including complete blood count, biochemistry, and chest X-ray, were normal. A pelvic computerized tomography (CT) scan was negative for retroperitoneal metastasis. The provisional diagnosis was paratesticular tumor, with the possibility of benign nature.\nThe patient was then referred to our institution for surgical treatment. The left inguinal approach was established and the left spermatic cord was identified. On visual inspection, the tumor arose from the tunica albuginea protruding into the testis parenchyma. Intraoperative frozen-section biopsy showed benign tumor from tunica albuginea. Subsequently, a right tumor resection including removing a portion of tunica albuginea was performed.\nFinal histological examination confirmed the diagnosis of AT from the tunica albuginea (). Immunohistochemical analysis revealed the tumor cells were positive for calretinin, cytokeratin, and vimentin (). The postoperative course was uneventful. After 12 months of follow-up, the patient was asymptomatic without any evidence of local recurrence.