Infarcted Adenomatoid Tumour of Paratesticular Tissue: Case Report

Although rare, testicular adenomatoid tumours are the most common benign neoplasms of the paratesticular region, particularly affecting the epididymis and spermatic cord. These benign mesothelial-derived tumours rarely undergo malignant transformation and are typically managed with surgical excision. However, their clinical presentation may mimic the tumours arising from the testis, either benign or malignant, leading to grave consequences.

We report the challenging case of a 49-year-old man who presented with a painful mass in the left scrotal lower pole. Owing to the suspicious imaging features, malignancy was initially considered. Histopathological examination revealed an infarcted adenomatoid tumour. This finding is rare and emphasises the importance of accurate diagnosis to avoid overtreatment. This case report describes the microscopic and macroscopic aspects of an infarcted adenomatoid tumour of the paratesticular area, focusing on the diagnostic and therapeutic approaches.

This case underscores the necessity for the careful clinical and imaging evaluation of paratesticular masses. In settings where intraoperative frozen-section analysis or advanced imaging modalities are available, the application of a conservative, testis-sparing approach may be feasible. Awareness of this rare presentation can help avoid overtreatment and guide tailored surgical decision-making. Multidisciplinary collaboration is essential to balance oncological safety with the preservation of testicular function in benign conditions that mimic malignant diseases.