Intratesticular lipoma in an elderly patient: A case report

Intratesticular lipoma is a rare benign tumor of the testis, with only a few cases documented in the literature. While extra testicular lipomas are more commonly observed, their presence within the testis is unusual. Due to the rarity of intratesticular lipomas, distinguishing them from malignant testicular tumors through non-invasive methods can be challenging, often requiring histopathological confirmation.

A 53-year-old male with hypertension presented with testicular enlargement. A scrotal ultrasound revealed a well-circumscribed, hyperechoic mass in the left testis, indicating a likely benign condition. Tumor markers (LDH, HCG, AFP) were normal. The patient underwent a left radical orchiectomy, which revealed a 6 × 6 × 4 cm yellow mass. Histopathology confirmed it as a lipoma with no malignant features.

Ultrasonography is commonly the first imaging tool for testicular masses, offering crucial insights. In this case, the hyperechoic appearance suggested a benign nature, although malignancy could not be fully excluded preoperatively. MRI can provide further differentiation between benign and malignant masses. The differential diagnosis for such testicular masses includes lipoma, dermoid cysts, and benign entities, though malignancies like seminoma may also appear. Surgical excision with histopathological evaluation remains essential for a definitive diagnosis.

Intratesticular lipomas, although rare, can mimic malignant testicular tumors. While radical orchiectomy is often performed for definitive diagnosis, preoperative evaluations, including imaging and tumor markers, are essential for proper management. Accurate differentiation between benign and malignant testicular masses is vital to avoid unnecessary interventions.