A 22-year-old male patient, with no history of interest except being a regular marijuana smoker, came to the emergency department complaining of increased left pouch intensity after sudden moderate physical exertion and pain 24 hours earlier.
No fever or voiding syndrome, no pain irradiation.
The patient had no associated neurovegetative cortex and no alterations in the intestinal rhythm.
Physical examination showed an apyretic and normotensive pattern, with good skin and mucous coloration.
The abdomen is blade and depressible, painless and without masses.
The renal fossae are free.
The right testicle did not present alterations, while in the left testicle a tumor of 2-3cm in diameter, non-mobile, was observed in the upper pole of the left testicle, with negative transition.
Analytically, there was no parameter out of normal.
In the testicular ultrasound both testicles show a normal echostructure with preserved Doppler flow, evidencing an extratesticular solid mass, in contact with the upper pole of the left 25mm testicle with vessels in its periphery.
The patient was admitted to hospital to complete the study and to filiate the lesion.
Preoperative staging was completed with chest X-ray, testicular tumor markers and general laboratory tests, and abdominal-pelvic CT without pathological changes.
Then, a surgical exploration was performed via inguinal approach where a left paratesticular mass slightly a cord was observed in its periphery, with smooth curves, nacarada and with a stony consistency, easy dissection with a cleavage plane.
A perioperative biopsy was taken which resulted in fibrous tissue without malignant cellularity.
Excision of the lesion was completed, leaving evidence and epididymis to avoid radical orchiectomy.
With an uneventful postoperative period, the patient was discharged two days after surgery.
The pathological report of the surgical specimen is a solitary fibrous tumor of the tunica vaginalis.
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In the postoperative control two years after surgery, the patient is asymptomatic without evidence of recurrence and disease-free.
