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Giant paratesticular spindle cell lipoma: A rare case report
Putu Kurnia Darma Pratama1, Tetuka Bagus Laksita1, Karinda Triharyu Caesari Putri2
1Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Urology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Introduction:
Spindle cell lipoma (SCL) is a rare condition primarily occurring in subcutaneous tissue. Only 4 cases of paratesticular SCL have been reported.
Case Presentation:
A 51-year-old man presented with a painless mass in his left testicle that has grown for nine years. Physical examination revealed a soft, smooth-surfaced left scrotal mass measuring 30 × 30 cm, which did not transilluminate. A contrast-enhanced abdominal-pelvic CT scan showed a paratesticular mass measuring 31.1 × 15.1 × 30.5 cm extending to the spermatic cord. Preoperative tumor markers, including Alpha-Fetoprotein (AFP), Human Chorionic Gonadotropin (HCG), and Lactate Dehydrogenase (LDH), were within normal ranges. Surgical exploration and excision successfully removed the tumor, measuring 39.0 × 37.0 × 16.0 cm and weighing 10 kg, revealing a spindle cell lipoma on pathology examination. Immunohistochemistry testing for CD34 was positive. Three months post-surgery, the patient was in good health with normal sexual function.
Discussion:
Paratesticular SCL is a benign neoplasm. Distinguishing spindle cell lipoma from liposarcoma radiologically is challenging. Therefore, a biopsy and histopathological examination are essential. CD34 Immunohistochemistry aids in determining SCL from liposarcoma. Complete excision following thorough preoperative preparation and accurate diagnostic procedures is recommended.
Conclusion:
Paratesticular SCL cases are rare, with good preoperative preparation and accurate post-operative diagnosis; good results will likely be expected, and this case report will likely contribute to ongoing research to enhance the understanding and management of paratesticular SCL cases.
