Mansiroglu Agah Koray, Duman Abdullah, Deniz Seher
Pediatric Surgery, State Hospital, Örtülüpınar Mah. İnönü, Sivas, Turkey.
Radiology, State Hospital, Sivas, Turkey.
BMC Urol. 2025 Apr 2;25(1):69. doi: 10.1186/s12894-025-01752-4.
Benign tumors of the spermatic cord constitute the majority of paratesticular tumors. Fibrolipomas are unusual in adults; however, there are no known cases involving the spermatic cord in children.
A male patient, aged 13, arrived at the emergency department complaining of right inguinoscrotal pain and nausea for the past four days. The genital examination of the patient revealed a tender, freely movable mass located in the right scrotum above the testicle. Doppler scrotal ultrasound demonstrated a soft tissue structure measuring 48 × 19 mm with heterogeneity and absence of vascular activity located along the spermatic cord in proximity to the right testicle. Right scrotal tenderness and absence of blood supply on Doppler ultrasound indicated emergency surgical intervention, considering the possibility of torsion in an accessory testicle, more frequently encountered in pediatrics. Surgical exploration of the inguinal region and mass excision were conducted. The pathology report determined a tumor exhibiting collagenized tissues surrounding fatty lobules, indicative of a fibrolipoma.
To our knowledge, this pediatric patient represents the first reported case of spermatic cord fibrolipoma. Although benign, fibrolipomas can present with acute scrotal symptoms and mimic more urgent conditions, such as torsion of an accessory testis. The possibility of fibrolipoma, while rare, should be considered in the differential diagnosis of a paratesticular mass to prevent misdiagnosis and potential testicular compromise. Optimal outcomes depend on early detection, accurate imaging, and prompt surgical intervention.
精索良性肿瘤构成睾丸旁肿瘤的大多数。纤维脂肪瘤在成人中并不常见；然而，儿童中尚无已知累及精索的病例。
一名13岁男性患者因过去四天来右侧腹股沟阴囊疼痛和恶心来到急诊科。对该患者的生殖器检查发现右侧阴囊内睾丸上方有一个触痛、可自由活动的肿块。阴囊多普勒超声显示一个48×19毫米的软组织结构，质地不均匀，位于右侧睾丸附近的精索上，无血管活动。右侧阴囊触痛及多普勒超声显示无血供，考虑到小儿更常见的副睾扭转可能性，提示需紧急手术干预。对腹股沟区进行了手术探查并切除了肿块。病理报告确定肿瘤表现为围绕脂肪小叶的胶原化组织，提示为纤维脂肪瘤。
据我们所知，该小儿患者是首例报告的精索纤维脂肪瘤病例。尽管纤维脂肪瘤是良性的，但可表现为急性阴囊症状并酷似更紧急的情况，如副睾扭转。在睾丸旁肿块的鉴别诊断中，虽纤维脂肪瘤可能性罕见，但应予以考虑，以防止误诊及潜在的睾丸损害。最佳治疗效果取决于早期发现、准确的影像学检查及及时的手术干预。
