Kalyvas V, Gkekas C, Papadopoulos D, Malioris A, Milias S, Papathanasiou M, Kalinderis N, Moysidis K, Hatzimouratidis K
2nd Department of Urology, Aristotle University of Thessaloniki, Greece.
Department of Urology, 424 General Military Hospital of Thessaloniki, Greece.
Case Rep Urol. 2019 Dec 23;2019:7606530. doi: 10.1155/2019/7606530. eCollection 2019.
Solid, fat-containing tumors of the testes are extremely rare with only a few cases having been reported so far, contrary to the more frequent occurrence of paratesticular lipomatosis. Testicular angiomyolipomas and gonadal involvement in Cowden's disease, although infrequently occurring, are known examples of fat-bearing testicular lesions. Hereby, we present an extremely rare case of intratesticular angiolipoma. Angiolipomas are benign tumors of the subcutaneous tissue commonly occurring in the trunk and the extremities. Histologically, they are characterized by ample vascularity and an excess of mature adipocytes. Definitive diagnosis is established by biopsy of the lesion.
A 35-year-old patient presented to our andrology outpatient clinic for fertility assessment. Physical examination of external genitalia revealed no significant pathology. Testicular ultrasound however depicted an isoechoic lesion on the upper pole of the right testis measuring 1.8 cm × 0.8 cm × 1 cm and exhibiting intense arterial flow. After sonographic and MRI investigation, the patient was referred for semen analysis and cryopreservation. Subsequently, the patient underwent testicular biopsy (frozen section biopsy) and right partial orchiectomy. Final histology reported a noninfiltrating testicular angiolipoma. No recurrences have been observed in the follow-up period.
Angiolipomas, which mainly occur in the trunk and extremities, are classified as infiltrating and noninfiltrating. The diagnosis is based on both clinical and histologic criteria, and the main method of treatment for both types is by surgical excision. The infiltrating type exhibits higher recurrence rates.
Angiolipomas commonly occur in the subcutaneous tissue and have been invariably treated by radical excision. Hereby, we report the first case of an intratesticular, noninfiltrating type angiolipoma which was treated by partial orchiectomy.
睾丸实性含脂肪肿瘤极为罕见，迄今为止仅有少数病例报道，与之相反，睾丸旁脂肪瘤的发生率则较高。睾丸血管平滑肌脂肪瘤以及考登病中的性腺受累，尽管较为罕见，但却是已知的含脂肪睾丸病变的例子。在此，我们报告一例极为罕见的睾丸内血管脂肪瘤病例。血管脂肪瘤是皮下组织的良性肿瘤，常见于躯干和四肢。从组织学上看，其特征是血管丰富且有过量的成熟脂肪细胞。通过病变活检可确立明确诊断。
一名35岁患者因生育评估前来我们的男科门诊。外生殖器体格检查未发现明显病变。然而，睾丸超声显示右侧睾丸上极有一个等回声病变，大小为1.8厘米×0.8厘米×1厘米，且有强烈的动脉血流信号。经过超声和磁共振成像检查后，患者被转诊进行精液分析和冷冻保存。随后，患者接受了睾丸活检（冰冻切片活检）和右侧睾丸部分切除术。最终组织学报告为非浸润性睾丸血管脂肪瘤。在随访期间未观察到复发情况。
血管脂肪瘤主要发生在躯干和四肢，分为浸润性和非浸润性。诊断基于临床和组织学标准，两种类型的主要治疗方法均为手术切除。浸润性类型的复发率较高。
血管脂肪瘤常见于皮下组织，一直通过根治性切除进行治疗。在此，我们报告首例经睾丸部分切除术治疗的睾丸内非浸润性血管脂肪瘤病例。
