Organized and Calcified Testicular Hematoma Mimicking a Neoplasm: A Case Report

Calcified intratesticular masses may mimic malignancy. Organized testicular hematomas are rare and may develop fibrosis and dystrophic calcification. Differential diagnoses include regressed ("burned-out") germ cell tumors, cavernous hemangiomas, and paratesticular fibrous pseudotumors (PFP).

A 60-year-old man presented with progressive right testicular swelling and dull aching pain. Imaging revealed a 5 × 4 × 4 cm solid, focally calcified intratesticular mass suspicious for neoplasia. Radical inguinal orchiectomy was performed. Histopathological examination revealed dense fibrocollagenous tissue, dystrophic calcification, organized hemorrhage, hemosiderin deposition, cholesterol clefts, hyalinization, and chronic inflammation, without evidence of malignancy.

This case highlights a rare organized, calcified testicular hematoma mimicking neoplasia. Histopathological examination is essential for definitive diagnosis. Organized hematoma should be considered when evaluating calcified intratesticular masses with chronic hemorrhagic and fibrotic changes. Regressed germ cell tumors and cavernous hemangiomas are important alternatives, whereas PFP should be considered when paratesticular origin is uncertain.