A Rare Case of Benign Testicular Fibroma

Background: Testicular fibroma is an extremely rare benign sex cord-stromal neoplasm of testicular matrix accounts about 4-5% of all testicular neoplasm and to the best of our knowledge less than 40 cases have been reported so far. It predominantly presented as a single painless mass with the mean size of 1.8 cm.The main differential diagnosis is solitary fibrous tumor, Leiomyoma and in cellular forms, malignant tumors such as fibrosarcoma and leiomyosarcoma should be considered .The tumor near always has benign clinical course and complete surgical resection is curative. Case report: We report a rare case of fibroma of the testis presenting as a single tumoral lesion of left testis in a 61 year-old man, since 8 months ago with evidence of hydrocele on physical examination. On MRI an enhancing well-circumscribed tumoral lesion on left testis is seen. Tumoral markers were within normal limits. The patient underwent orchiectomy and the cut sections of the specimen show a firm well-demarcated tan yellow mass composed of bland looking spindle cells with elongated nuclei and scant cytoplasm arranged in storiform and fascicular pattern on microscopy with diffuse positive immunoreaction for vimentin and SMA .The 3 months follow up of the patient revealed no tumoral recurrence. Conclusion: This case indicate that fibroma is a rare testicular neoplasm, which although has a benign behavior, but might have some worrisome histologic features, stimulating of testicular sarcoma and must be kept in mind in differential diagnosis of testicular spindle cell neoplasms.

Keywords:

testicular fibroma , gonadal stromal tumor , fibrothecoma , fibrous lesion of testis