Fibroma of the Testis and Epididymis: A Case Report on a Testis-Sparing Management Approach

Paratesticular fibromas are rare benign lesions that may clinically mimic malignancy and lead to unnecessary orchiectomy. We report the case of a 22-year-old man who presented with a firm, painless right paratesticular mass that was suspicious for neoplasm on physical examination. Serum tumor markers were normal, and imaging demonstrated multiple well-circumscribed fibrous extratesticular lesions compressing, but not invading, the testis. Surgical exploration revealed multiple firm, whitish nodules involving the epididymis and testicular tunics, and testis-sparing excision was performed. Histopathologic examination showed well-circumscribed, collagen-rich spindle-cell lesions without cytologic atypia or mitotic activity, favoring benign paratesticular fibroma. At the six-month follow-up, the patient remained asymptomatic, with no evidence of recurrence on ultrasonography. This case illustrates the potential role of organ-preserving surgery in carefully selected patients when imaging and intraoperative findings suggest a benign fibrous lesion and complete excision can be achieved without compromising oncologic safety.