Zheng Weitao, Shi Ming, Li Tao, Xu Hang, Chen Zeyu, Wang Xingyuan, Bai Shengjiang, Le Weizhen, Yang Lu, Wei Qiang
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
Department of Gynecology and Obstetrics, Development and Related Disease of Women and Children Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China.
Transl Androl Urol. 2021 Feb;10(2):983-990. doi: 10.21037/tau-20-1073.
Mesenchymal neoplasms of the scrotum are extremely rare in the clinical practices, in which lipoma is the most common benign neoplasm of them. Primary scrotal lipoma refers to the lipoma originated from scrotal wall. We reported a rare case of a 47-year-old man who suffered from bilateral giant primary scrotal lipoma along with lipomas in multiple sites of the body. Scrotal ultrasound indicated that huge hypoechogenic masses were observed in the bilateral scrotums. Contrast-enhanced computed tomography (CT) indicated increased fat density in the scrotal areas. Surgical resection was performed on both scrotal neoplasms. Diagnosis of lipoma was confirmed by the pathological examination through the morphological observation as well as the absence of murine double minute2 (MDM2) gene amplification in the fluorescence in situ hybridization (FISH) test. After five months of follow-up, the wound of the patient recovered well and no sign of local recurrence was observed. Based on the literature review, very few cases of primary scrotal lipoma were reported in the scientific literature up to date, and this is the first report of bilateral primary scrotal lipoma along with multiple lipomas of the body. We presented this case as a rare phenomenon. Although primary scrotal lipoma is rare, clinicians should take it into account when encountering similar scrotal lesions and know the methods for diagnosis and how to make differential diagnosis with other diseases, which is associated with the patient's treatment strategy and prognosis.
阴囊间叶组织肿瘤在临床实践中极为罕见，其中脂肪瘤是最常见的良性肿瘤。原发性阴囊脂肪瘤是指起源于阴囊壁的脂肪瘤。我们报告了一例罕见病例，一名47岁男性患有双侧巨大原发性阴囊脂肪瘤以及身体多个部位的脂肪瘤。阴囊超声显示双侧阴囊内可见巨大低回声肿块。增强计算机断层扫描（CT）显示阴囊区域脂肪密度增加。对双侧阴囊肿瘤进行了手术切除。通过形态学观察以及荧光原位杂交（FISH）检测中鼠双微体2（MDM2）基因无扩增，病理检查确诊为脂肪瘤。经过五个月的随访，患者伤口恢复良好，未观察到局部复发迹象。基于文献综述，迄今为止科学文献中报道的原发性阴囊脂肪瘤病例极少，这是首例双侧原发性阴囊脂肪瘤伴身体多处脂肪瘤的报告。我们将此病例作为一种罕见现象呈现。虽然原发性阴囊脂肪瘤罕见，但临床医生在遇到类似阴囊病变时应予以考虑，并了解诊断方法以及如何与其他疾病进行鉴别诊断，这与患者的治疗策略和预后相关。
