Fujiwara Kengo, Fujimoto Kengo, Ibuki Emi, Ishikawa Ryo, Hayashida Yushi
Department of Urology, Sakaide City Hospital, Sakaide, Japan.
Department of Radiology, Sakaide City Hospital, Sakaide, Japan.
Front Urol. 2024 Jun 3;4:1400674. doi: 10.3389/fruro.2024.1400674. eCollection 2024.
Spindle cell lipoma is a relatively rare benign tumor that can occur in the posterior neck, shoulder, and upper back. Herein, we present a case of intrascrotal spindle cell lipoma in a 71-year-old male who presented with a mass in the left scrotum that had developed over 2 years. Contrast-enhanced computed tomography (CT) revealed a 5.7cm mass accompanying enhanced solid components. Magnetic resonance imaging (MRI) showed a heterogeneous signal intensity. Therefore, a well-differentiated liposarcoma derived from the spermatic cord was suspected; therefore, the patient underwent radical inguinal orchidectomy with high ligation of the spermatic cord. Histopathological examination revealed mature adipocytes and bland-spindle cells. Immunohistochemically, the tumor cells were positive for CD-34 and negative for CDK4, MDM2, and p16. These findings indicated a spindle cell lipoma. Surgical margins were negative. Three months after surgery, no relapse was observed. This case underscores the rarity of para-testicular spindle cell lipoma. While CT and MRI play crucial roles in disease diagnosis, they may not detect all lesions. To prevent overtreatment, it's essential to also consider pre-surgical examinations and intraoperative findings.
梭形细胞脂肪瘤是一种相对罕见的良性肿瘤，可发生于颈后部、肩部和上背部。在此，我们报告一例71岁男性阴囊内梭形细胞脂肪瘤病例，该患者左侧阴囊出现肿物，已持续2年。增强计算机断层扫描（CT）显示一个5.7厘米的肿物，伴有强化的实性成分。磁共振成像（MRI）显示信号强度不均匀。因此，怀疑是起源于精索的高分化脂肪肉瘤；于是，患者接受了腹股沟根治性睾丸切除术及精索高位结扎术。组织病理学检查显示成熟脂肪细胞和平淡的梭形细胞。免疫组化检查显示肿瘤细胞CD-34阳性，CDK4、MDM2和p16阴性。这些结果表明是梭形细胞脂肪瘤。手术切缘阴性。术后三个月，未观察到复发。该病例强调了睾丸旁梭形细胞脂肪瘤的罕见性。虽然CT和MRI在疾病诊断中起关键作用，但它们可能无法检测到所有病变。为防止过度治疗，术前检查和术中发现也很重要。
