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 30 year-old male presented with a right-sided, tender scrotal swelling of four days’ duration. He had no significant past medical history or history of trauma. On local examination, a firm, mobile, and tender mass measuring 2 × 2 cm was found; the contralateral testis was normal. A clinical diagnosis of tuberculous epididymitis or testicular neoplasm was made. Routine hematological and biochemical investigations, urine analysis, and a chest radiograph revealed no abnormalities. USG of the scrotum showed a well defined, hypoechoic mass measuring 2.5 × 2 cm in the region of the globus major of the right epididymis. Aspiration was done using a 10 mL syringe and a 24 gauge needle to yield a scanty, grey-white aspirate. The smears were stained with H and E, Papanicolaou, and MGG stains. The cytological features were similar as those of case 1 and a diagnosis of an adenomatoid tumor was made. The patient underwent a conservative testis-sparing surgery with the excision of the epididymal nodule. The nodule measured 2 × 2 cm and the cut section was grey-white with microcysts. The results of the histopathological investigation were consistent with features of an AT.