Yang Jiali, Chen Hongyan, Yan Hualin, Zhang Yue, Liu Juxian
Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Front Oncol. 2024 Dec 24;14:1485723. doi: 10.3389/fonc.2024.1485723. eCollection 2024.
To investigate the clinical and ultrasound features of fibrous pseudotumor of tunica vaginalis of the testis.
The clinical and ultrasound features of fibrous pseudotumor of the tunica vaginalis diagnosed by pathology in West China Hospital of Sichuan University from 2006 to 2023 were retrospectively analyzed.
The study included 8 patients diagnosed with fibrous pseudotumor of the tunica vaginalis. The average age was 51.8 ± 17 years(range:25 to 80 years). Painless nodules or masses were present in 87.5% of cases, while 12.5% presented with painless scrotal enlargement. Ultrasound findings were as follows: Lesions were nodular in 7 cases and diffuse in 1 case (left side 50%, right side 50%). 75% involved the tunica vaginalis wall; 25% involved the epididymis with concurrent epididymitis. The tunica vaginalis wall on the affected side was significantly thicker than the contralateral side (4.58 ± 2.19 mm vs. 2.59 ± 0.48 mm, =0.012). Hydrocele was present in 62.5% of the affected cases, poor sound transmission was noted in 62.5%, and septation was observed in 12.5%. 62.5% of cases exhibited multiple small solid nodules, with a maximum diameter ranging from 8∼19 mm. Nodules were well-circumscribed, regularly shaped and isoechoic or slightly hyperechoic. In 37.5% of cases, adjacent nodules were fused and 37.5% exhibited posterior attenuation. Punctate calcifications were present in 25% of cases. There is usually less blood flow in the lesion.
This study demonstrates that fibrous pseudotumor of the tunica vaginalis is a rare scrotal disease affecting primarily middle-aged and elderly men. It typically presents unilaterally and carries a favorable prognosis following surgical treatment. Ultrasound commonly reveals multiple slightly hyperechoic or isoechoic solid nodules with ipsilateral thickening of the tunica vaginalis wall. In some cases, nodules may involve the epididymis, with associated epididymitis, fusion of adjacent nodules, occasional calcification, and posterior echo attenuation. Most lesions exhibit poor blood flow, and hydrocele is frequently present on the affected side. The distinct clinical and ultrasound features of the disease make non-radiative ultrasound imaging an effective tool for rapid detection, differential diagnosis, and guidance for appropriate clinical treatment.
探讨睾丸鞘膜纤维性假瘤的临床及超声特征。
回顾性分析2006年至2023年在四川大学华西医院经病理诊断的睾丸鞘膜纤维性假瘤的临床及超声特征。
本研究纳入8例诊断为睾丸鞘膜纤维性假瘤的患者。平均年龄为51.8±17岁（范围：25至80岁）。87.5%的病例表现为无痛性结节或肿块，12.5%表现为无痛性阴囊增大。超声表现如下：7例病变为结节状，1例为弥漫性（左侧50%，右侧50%）。75%累及鞘膜壁；25%累及附睾并伴有附睾炎。患侧鞘膜壁明显厚于对侧（4.58±2.19mm对2.59±0.48mm，P=0.012）。62.5%的患侧病例存在鞘膜积液，62.5%可见透声差，12.5%可见分隔。62.5%的病例表现为多个小实性结节，最大直径为8～19mm。结节边界清晰，形态规则，等回声或略高回声。37.5%的病例相邻结节融合，37.5%表现为后方衰减。25%的病例有斑点状钙化。病变内血流通常较少。
本研究表明，睾丸鞘膜纤维性假瘤是一种罕见的阴囊疾病，主要影响中老年男性。它通常单侧发病，手术治疗后预后良好。超声通常显示多个略高回声或等回声实性结节以及患侧鞘膜壁增厚。在某些情况下，结节可能累及附睾，并伴有附睾炎、相邻结节融合、偶尔钙化及后方回声衰减。大多数病变血流较少，患侧常伴有鞘膜积液。该疾病独特的临床和超声特征使超声成像成为快速检测、鉴别诊断及指导临床合理治疗的有效工具。
