A 61-year-old male patient with no past medical history came to our service because of a right tumor appeared three years ago. He grew slowly without pain and left hernia.
In the physical examination, the right testicle seemed to be located towards the root and a mobile mass of elastic and soft consistency of about 15 cm occupying the entire hemiscrotum was observed.
The clinical diagnosis was mental illness.
Blood and urine tests, chest X-ray and electrocardiogram were all normal.
Ultrasound was not performed and intervention was decided.
During the operation, first, the left inguinal hernia was repaired with a prolene mesh and then the right hemiscrotum was explored.
Through a first cutaneous and right incision we try to isolate a vesicular mass whitish.
However, due to the difficulty we had in separating the neoformation of surrounding tissues and finding the right testicle, which was resolved by the mass, we chose another pathway.
A second inguinal scrotal incision was made through which, by blunt dissection, it was easier to isolate the neoformation, which extended superiorly to the level of the external inguinal ring.
Once the cord was isolated, it was impossible to bring the testicle out, which had a hypotrophic aspect but was not affected.
Resection of the mass was also easier and safer.
The margins of the lesion were well delimited and easy to separate, except for a zone at the bottom of the pouch, where the neoformation was more adherent to the dart.
The macroscopic aspect of the removed neoformation was an elongated mass of 15 x 7 x 5cm and weight of 140 gr apparently encapsulated with regular external surface.
Upon cutting, the surface was uniform, dense and fibrotic, with a whitish color and elastic consistency without evidence of myxoid degeneration or necrosis.
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Microscopic examination showed a tumor composed of groups of spindle cells, undulating and hyperchromic, closely interposed in bundles of collagen fibers.
Immunohistochemistry showed cytoplasmic positivity for S-100 protein.
No signs of necrosis, mitosis or nuclear atypia were documented.
The definitive histopathological diagnosis was neurofibroma.
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One year after the intervention, no objective signs of recurrence were revealed.
